How the Mid-Victorians Worked, Ate, and Died

Public Health Patterns

The overall pattern of Victorian causes of death broadly resembles that found in developing countries today, with infection, trauma and infant/mother mortality in the pole positions, and non-communicable degenerative disease being relatively insignificant.

Common causes of death [65,66]

1. Infection including TB and other lung infections such as pneumonia; epidemics (scarlet fever, smallpox, influenza, typhoid, cholera etc), with spread often linked to poor sanitation: and the sexually transmitted diseases.
   
   
2. Accidents/trauma linked to work place and domestic conditions. Death from burns was an important cause of death among women, due largely to a combination of open hearth cooking, fashions in dress, and the use of highly flammable fabrics.
   
   
3. Infant/mother mortality [66]. This was generally due to infection, although maternal haemorrhage was another significant causative factor.
   
   
4. Heart failure. This was generally due to damage to the heart valves caused by rheumatic fever, and was not a degenerative disease. Angina pectoris does not appear in the registrar general's records as a cause of death until 1857 – and then as a disease of old age - although the diagnosis and its causes were recognised [67–70].
   

Uncommon causes of death

5. Coronary artery disease (see above)
   
   
6. Paralytic fits (strokes, see Webster's Dictionary). Stroke was mainly associated with the middle and upper classes who ate a diet in which animal derived foods had a more significant role, and who consumed as a result rather less fruits and vegetables. Strokes were generally non-fatal, at least the first time; although mortality rates increased with each subsequent stroke [65]
   
   
7. Cancers were relatively rare [65]. While the Victorians did not possess sophisticated diagnostic or screening technology, they were as able to diagnose late stage cancer as we are today; but this was an uncommon finding. In that period, cancer carried none of the stigma that it has recently acquired, and was diagnosed without bias. For example, in 1869 the Physician to Charing Cross Hospital describes lung cancer as '… one of the rarer forms of a rare disease. You may probably pass the rest of your students life without seeing another example of it'. [71].

Not only were cancers very uncommon compared to today, they appear to have differed in other key respects. James Paget (of Paget's Disease) built a large practice on the strength of diagnosing breast cancer, which he did by sight and palpation – that is at Stages 3 and 4. In this group he describes a life expectancy of 4 years after diagnosis, extending to eight or more with surgery [72].

The corresponding figures today are Stage 3: 50% survival at 10 years if given surgery, chemo- and radio-therapy, and Stage 4: overall survival about 15 months. These figures suggest that breast cancer during the Victorian period was significantly less rapidly progressive than is the case today, probably due to the Victorians' significantly higher intakes of a range of micro- and phytonutrients which slow cancer growth.

In summary, although the mid-Victorians lived as long as we do, they were relatively immune to the chronic degenerative diseases that are the most important causes of ill health and death today.