As someone who transcribes old cemetery records, I lost count of the number of people who died from tuberculosis. It was staggering. It seemed to overwhelm all other causes of death, and it usually didn’t stop at one family member.
Every once in a while, you were hoping to see another cause of death just to break up the monotony. There were a few, such as “kicked by a horse” or “died of old age” at 62 years, along with the occasional “dropsy” and “stroke”, but “consumption” won, hands down, at least in the cemetery records I transcribed.
On the vaccine side, it was easy to go through old church records on the US Eastern seaboard and find pockets of smallpox that also killed off large segments of family. This was prominent in the 1600 and 1700 records. As Jenner’s vaccine made inroads, you see that less and less smallpox in the 19th century.
It’s also easy to infer a smallpox incident when none are explicitly indicated. What else would quickly kill family members of different generations within weeks of each other? Probably smallpox. Yes, there could be other things, but when smallpox is happening around the area, it’s a reasonable deduction.
In 21st Century mode, we’re ignorant of how life has changed and how vulnerable we were to shortened life spans in the past. I knew that at an abstract level, but if you really want to see the magnitude, read through death and/or burial records prior to the early to mid 20th century. It’s quite an education.
In 1900, the 3 biggest causes of death were infections. Of those, the top 2 were lung infections. Thats interesting. I wonder why lung infections were so much more fatal than infections of any other body part. I guess because they are the most contagious due to coughing, I don’t know.
Lungs need to be constantly functional to keep you alive. You can take a couple of days, or weeks/months if you have a support network, of your leg or arm or eye or whatever being out of commission. Lungs stop working for five minutes and its all over.
In theory, infections of the heart should be just as lethal if not more. But unlike your heart lungs draw liters of foreign material into your body every breath you take. Into a warm, wet, well-aired environment with a massive surface area. Lungs are going to see a lot of pathogens and provide a fairly pleasant environment for them.
Scarlet fever also killed off whole families in a matter of days. There’s no vaccine for it, but even before penicillin came out, the disease’s virulence started to dramatically decline, for reasons that are still unknown.
Insulin was discovered in 1922, and that also contributed to a reduction of the pediatric death rate. Prior to this, type 1 diabetes was an automatic death sentence.
Kidney failure was also a death sentence until mid-century, when dialysis and transplants made it less so.
Even eliminating all these deaths would not decrease child mortality by that much. Anyway, I was in kindergarten when the polio vaccine came out, and way before MMR. People lived in fear of polio - not so much for measles. It was considered no big deal, and lots of parents exposed their kids to friends with measles to get it over with.
And I’m in no way saying MMR and other vaccines are not wonderful. They are.
Not in this country, but in some lesser developed areas, that has been the case.
Back when tuberculosis was endemic, it often flared after a person recovered from measles, and the reason was not fully understood until the past few years.
It is difficult to imagine how insanitary conditions were for ordinary folk in the past.
Burning coal was THE source of energy for heating and rail transport. Cities shrouded in air pollution from millions of domestic fireplaces along huge factories belching out smoke.
The introduction of the automobile replaced horse power within 10 years from 1900 and would have had some clear health benefits. Horse power was utterly polluting in big cities. Compare the amount of effluent produced by a horse drawn bus. A team of six, with several changes for a regular service, compared to a bus powered by an internal combustion engine. Before these innovations there was a crisis in the major world cities. The great horse manure crisis of 1894. Quite apart from the effluent on the streets, the amount of dust and flies must have made life in the city unbearable at times.
At the same time, electricity networks developed and one of its first applications was the electric tram streetcar and domestic food refrigeration. These were huge advances that were rolled out between WW1 and WW2. Moreover these Wars led to a big expansion in the state and investment in the health and welfare of the population. You don’t win a war if your are recruiting your soldiers from a weak and sickly population. This was most evident in WW1 and it led to many social reforms afterwards to take care of the millions of men who returned with disabling injuries.
I am sure the whole grim history of the twentieth century is all there in the mortality statistics.
If I understand this correctly, measles causes damage to the immune system for some time after the patient apparently recovers, something which was not known at the time the measles vaccine came out. So, in other words, you’d get a lot of kids dying of apparently unrelated infections within a year or two of having measles, and these are not deaths that would have been labeled as complications of measles at the time – people made the correlation between the vaccine and the falling rate of childhood deaths from other causes much, much later.
As nearwildheaven pointed out, measels have much higher mortality in less developed nations among mal- or undernourished kids. I suspect the mortality reduction would have been much higher in some nations than others.
Today, I came across an article that reminded me of this thread.
It is about Professor Christine Stabell Benn, who noticed that the introduction of the measles vaccine coincided with a halving of mortality when it was introduced to poor nations in the 1970 and 80s, in spite of the fact that measles did not kill anywhere near that many people. On further investigation it seems that similar if not quite so large effects accompanied the introduction of the Calmette vaccine in the 1920s, MMR in the 1980s as well as the vaccines against polio and smallpox. The theory appears to be that a live, as opposed to inactivated, vaccine protects against more than the disease it inoculates against. The immune system gains some broad competence in fighting off diseases that work in similar ways. The effect appears less pronounced in wealthier nations where children are well fed and as a consequence have stronger immune systems to start off with.
But the effects can be up to 30 - 40 % reduction in other diseases with all four current live vaccines.
The article is here, it is unfortunately in Norwegian but it has a good reference section.
Some time ago, we figured out at my workplace that lacking modern medicine, I would have been the only one who would have lived to be 20 (there were 5 or 6 of us, can’t remember). And of course, lacking modern medicine, I could have died during some random epidemic precisely prevented by modern medicine.
Of course, it’s not representative. It’s random chance that all my coworkers had some serious medical issue (say, appendicitis) before 20. It’s till striking.
The median age of death during the late middle ages/early renaissance was 10. Half the babies were doomed to die before they would be ten. People living to be 20 had a life expectancy of about 25 years more. Reaching 50 was already beating the odds assuming you had reached adult age. Life expectancy for people living to be 20 (so excluding all deaths during childhood/adolescence) reached 60 only during the late 19th century.
