Second Opinions: Epidemics and Infections in Nineteenth-Century Britain

Extract

In a recent BBC Radio 4 programme, the presenter observed that ‘It used to be normal to die of infectious disease, then it was normal to die of heart disease, now it's normal to die of cancer.’ ¹ The expert being interviewed accepted the claim and so would most historians of medicine. What was being referred to was, of course, the modern epidemiological transition—the transition of cause specific mortality, culminating in the twentieth century when degenerative replaced infectious diseases as the main causes of death. So, when exactly was it normal to die of infectious disease? Most students of British history would answer the nineteenth century and earlier, although it is the Victorian era from the 1840s to the 1900s that has received the most attention and it is on this that we focus. That said, the views on changes in the causes of mortality in industrialised countries that we wish to challenge are common across the international community. We concentrate on Britain because we have limited space, it is the country we know best, and because its mortality experience has been subjected to the most exhaustive analysis and debate. ²