Mary Phippen slipped gently from life in 1909 at the age of 92. Born in 1816, just a few months after the Battle of Waterloo, she grew up by candle-light, never went to school and never knew a childhood without work. She went on to celebrate the coronation of Queen Victoria, wave goodbye to her husband Robert as he sailed to war in a three-decker sailing ship, marvel at the arrival of railways, photography, electricity and the first motor cars, and, through the dimming perceptions of creeping senility, greet the dawn of aviation.
My great great grandmother wasn’t alone in her longevity. Her father Richard Bartlett died of “natural decay” at 82 and her mother lived to be 87. Mary’s husband Robert Phippen died at 82, his parents died at 84 and 85, and his grandparents died at 79 and 85. Three quarters of my ancestors born in the 1700s and 1800s lived into their sixties and beyond, two-thirds lived past 70, and a quarter lived into their 80s.
How can that be? Aren’t we today living longer and healthier than at any time in the past? Aren’t we the beneficiaries of all the gifts of modern medical science?
Perhaps not.
The biggest change in our lives over the last 150 years has been the eradication of infant mortality. This isn’t the result of modern medical miracles, but is instead the outcome of enlightened public health policy that addresses issues as basic as access to clean drinking water and decent plumbing.
Clapham in 1808
Let’s begin by looking at just one year in the village of Clapham, a relatively well-to-do suburb of London on the south bank of the Thames in Surrey. The burial register for Clapham’s parish church (one of three churches in the village) provides a window on life (and death) 200 years ago (images of pages from the register are on line at ancestry.co.uk if you want to look for yourself).
One hundred and fourteen burials were recorded in the parish register in 1808. The youngest was Mary Thorowgood Keable, the daughter of a pastry cook, who was baptised immediately after she was born and died after just 24 hours. The oldest was Mary Clark, “a Spinster aged 90 years or more, from the Workhouse.”
Some of the more noteworthy burials included 26-year-old William Baker, who died accidentally “carrying a sack of coals for a wager;” 52-year-old William Westbrook, who “put an end to his existence in a fit of insanity;” and the man who was found “drowned in the right Honourable Lord Teignmouth’s pond, name unknown.”
The biggest cause of death was “Consumption,” known today as tuberculosis or TB, which struck a third of the working age men and women who died that year.
This parish register is sad reading, but saddest of all is the story of Clapham’s children.
More than half the burials recorded in 1808 were children under the age of ten. A third were under the age of two.
That year a severe epidemic of measles swept through London. In Clapham it took eleven babies and children. Six others died of convulsions. Three died of causes unknown.
Richard Prescott, aged 11 months, died of Whooping Cough. Jemima Cicely Williams, aged two years, died of “water on the brain.” Maria Daniels, aged four months, was taken by a “Complaint in the bowels.” John Blakely, aged five, died of “inflamation on the lungs.” And the list goes on.
Death was no respecter of class: Thomas Looker succumbed to whooping cough in the Poor House in January, aged one year nine months; Lea Guillebaud, son of the Reverend Peter Guillebaud and his wife Eliza Ann, was taken a few weeks later, aged 11 months,succumbing, bizarrely, to “cutting teeth.”
We’re led to believe that families were big 200 years ago, but perhaps families weren’t as big as we think. While it’s true that women gave birth to many children, this may only have ensured a decent chance that a few of their offspring would survive to become adults. I struggle to imagine the perpetual pall of mourning hanging over Clapham, with every household grieving the loss of so many young souls.
High infant mortality explains why the average age at death in Clapham in 1808 was just 28. People who survived past the age of ten could expect to die at an average age of 50. A third of them would live long enough to qualify as old age pensioners, except that there were no old age pensions in 1808.
It’s easy to believe that the story of our growing average life expectancy is one of great medical breakthroughs by pioneering researchers. That’s part of it of course, but a much smaller part than many of us believe. The biggest results have come from the more mundane focus on public health: clean drinking water, better sanitation and less crowded living conditions.
Life in Victorian London
Two hundred years ago most people shared communal public toilets, or privies, from which waste would be dumped into cesspits or street gutters or in London would flow through sewers directly into the River Thames. Drinking water was usually drawn from wells contaminated by seepage from the privies and cesspits and in London drinking water was drawn untreated directly from the river. Only the wealthy could afford to wash regularly, or to dress in clean clothes. It was common for clothes and hair to be infected with lice.
The vast majority of the population in London and other cities and towns lived in crowded tenements, whole families packed into tiny flea, roach and rodent-infected rooms with communal kitchens, where kitchens existed at all.
Henry Mayhew was a crusading journalist who wrote in the mid-19th century about the lives of the poor in London. He wrote of the lodging houses that catered to the poorest of London “with rooms so crammed with sleepers - [someone he interviewed] believed there were 30 where 12 would have been a proper number - that their breaths in the dead of night and in the unventilated chamber, rose . . . ‘in one foul, choking steam of stench’.” Here someone would scrape together “a handful of bugs” from the bedclothes and crush them under a candlestick. According to Mayhew it was common to get drunk each evening just so that it would be possible to sleep a full night through the stench and the bugs.
He wrote of a street were there were “dead decaying cats and fish, with offal, straw, and refuse scattered over the surface; at one end an entrance to a private yard was used as a urinal; in every part there were most offensive smell.” He described another area that had an “abundance of ordinary filth arising from the exposure of refuse, the surface of the court contained heaps of human excrement, there being only one privy to the whole court, and that not in a state to be publicly used . . .”
He described a creek that had become nothing more than an open sewer, draining directly into the Thames: “. . . the open doorless privies that hung over the water-side, and the dark streaks of filth down the walls, where the drains from each house discharged themselves into the ditch, were proofs indisputable as to how the pollution of the ditch occurred . . . In [the water] floated large masses of rotting weed, and against the posts of the bridges were swollen carcasses of dead animals, ready to burst with the gases of putrefaction. Along its shores were heaps of indescribable filth . . .”
On one street Mayhew came across the home of a barber. “. . . When the scarlet fever was raging in the neighbourhood, the barber who was living here suffered fearfully from it, and no sooner did the man get well of this than he was seized with typhus, and scarcely had he recovered from the first attack of that, than he was struck down a second time with the same terrible disease. Since then he has lost his child from cholera, and at this moment his wife is in the workhouse suffering from the same affliction. The only wonder was that they are not all dead; for as the barber sat at his meals in his small shop, if he put his hand against the wall behind him, it would be covered with the soil of his neighbour’s privy, sopping through the wall.”
Is it any wonder that people died in London at an early age? These living conditions were ideal for any number of infectious diseases, including smallpox, tuberculosis, scarlet fever, whooping cough, diphtheria, dysentery, cholera and measles. Their victims, especially infants and children, were already sickly and malnourished, ready to be taken.
And taken they were. England in 1841 had a population of about 16 million. Between 1838 and 1848 some 160,000 deaths were attributed to typhus. Measles and whooping cough claimed 50,000 between 1838 and 1840. Cholera took 52,000 in 1832, another 50,000 in 1848 and 36,000 in 1853 and 1854. 1848 was an especially bad year: the country was ravaged not only by typhus and cholera, but also by dysentery and influenza which alone took another 13,000. The number of deaths caused by consumption was horrific - perhaps up to a quarter of all deaths in England in the 1840s.
Smallpox and Public Health Policy
Of all these diseases, smallpox was perhaps the most widespread and most dreaded. It was also the first to be conquered.
It’s likely that every person living in England in the 1700s was exposed to smallpox at some point in his or her life and it was the cause of death for one in five. Passed from a victim’s respiratory tract, the smallpox virus was transmitted to others through a victim’s clothing, through corpses and through the air, often wafting through every lane and alley in whole villages and neighbourhoods.
After a 12-day incubation period, patients first noticed a high temperature, headaches and sometimes vomiting. Then a rash would appear, first on the face and then on the rest of the body. The rash would turn into pustules which gave off a stinking odour.
Some victims would pass away peacefully. Others would die in agony, unable to drink or eat, retching blood from their lungs.
Often survivors were left weakened, unable to fend off other diseases. Some were blinded; others found their faces horribly disfigured; and most survivors were scarred for life.
My great, great, great grandfather George Hickford’s second wife Mary passed away in 1839 in Ashen, Essex. The parish register records that she “died of smallpox sometime between 3 and 4-o-clock on Sunday, June 16; buried shortly after midnight; service given at 10:00 am same day.” This kind of haste was common then - corpses had to be buried quickly and kept from others in the community.
In 1700 as many as one in five of all deaths were caused by smallpox, but by the beginning of the 19th century, this horrible disease was starting to be controlled. Inoculation, the practise of developing immunity by exposing someone to a mild form of the disease (by opening a vein and introducing puss directly into the blood), had been discovered in the Middle East and was brought to England early in the 18th century. It was widespread by the 1750s. Then, the turn of the century saw the introduction of inoculation with cowpox, or vaccination as it became known.
At first, only the wealthy were inoculated, but eventually the authorities realised the benefits of inoculating the poor as well and began to pay for the introduction of the practise in the poorest neighbourhoods throughout the country and then, in the middle of the 19th century, to legislate mandatory vaccination for everyone. This was the first example of a disciplined public health policy, and although occasional outbreaks continued until as late as 1881, it was a success. By the 1850s, in the rural health district of Halstead, Essex (which included the village of Toppesfield, where my ancestor Edward Nice and his family lived), less than one half of one percent of all deaths were attributed to smallpox. By the 1880s there were no smallpox cases reported at all.
The 19th century saw a steady progression of other public health initiatives.
The first public health act was passed in 1848. Others followed in 1872 and 1875.
The “Great Stink” of 1858, when the stench of untreated human waste in the Thames was so strong that it prevented work in the courts and in the House of Commons, prompted the authorities to finally deal with the raw sewage that was ending up in the river. Over the following ten years modern sewers and pumping stations were constructed to carry waste down river past the city.
At the same time water distribution companies started taking advantage of the availability of steam engines to pump cleaner drinking and washing water from further upstream on the Thames into most areas of London. Soap was by then also becoming much cheaper and more readily available.
The public health act of 1875 governed water supply and sewage, including the construction of new toilets. Henceforth these had to have at least one outside wall with a window, their own water supply and a separate pipe leading to a sewer. That year the Artisans and Labourers Dwellings Act empowered local authorities to demolish housing with inadequate drainage or sewage disposal facilities.
The Impact on Woolwich
Slowly these measures and others began to change the quality of life for people living in England, with a direct affect on their life expectancy. Nowhere is this more apparent than in Woolwich. Surrounding the Royal Docks, the Royal Arsenal and a large army barracks, this London neighbourhood grew rapidly in the second half of the 19th century.
Many of my ancestors moved to Woolwich at that time: John Street and his family in 1861, Harry Berryman and his family in 1889, Alfred Nice and his brother and sister and their families in the 1890s and Richard Campbell and his son in 1903.
An analysis of records published by Free BMD at freebmd.org.uk shows that in 1869 the average age at death in Woolwich was 25 and the median age (the age below which half of all deaths occurred) was just 10. Almost 38% of all deaths in the neighbourhood were children under the age of two and only a quarter of those who survived childhood could expect to live to age 65 or beyond. These statistics are not much different from those of the Clapham of sixty years earlier, where the average age at death was 24 and the median age was six, but where 32% of adults could expect to pass 65.
By contrast, in the Halstead district in 1867 the average age at death was 38 and the median age was 35, and amongst those who survived childhood almost half could expect to live past 65. The countryside really was healthier in those days.
Jump forward to 1907 and the picture has changed for the better. That year the average age at death in Woolwich was 32 and the median age was 27. Amongst those who survived childhood almost 40% could expect to live past 65. This was a big change in 40 years, but the contrast with Halstead had grown even greater. There, the average age at death had increased to 50 and the median age was 60. Some 60% of all adults could expect to live past 65.
After that, though, Woolwich’s statistics improve dramatically and the gap with Halstead narrows. By 1927 the average age at death in Woolwich was 53, compared to 65 in Halstead, and the median age was 62 compared to 70 (yes, by 1927 half of all people who died in Halstead died past the age of 70!). By 1947 the average age at death in Woolwich had leaped to 64 and the median age was 69. In Halstead the comparable numbers were 69 and 73 respectively. The biggest factor driving these numbers was the drop in infant mortality, from 38% in 1869 to just 5% in 1947.
These numbers are astounding. In Woolwich between 1869 and 1947 the median age of death increased from ten years to 69. And yet this was in an era before the introduction of universal health care, before the widespread use of antibiotics and before the introduction of MRIs, CatScans, ultrasounds, defibrillators, pacemakers, lung transplants, open heart surgery and every other modern medical miracle.
In the 78 years between 1869 and 1947 the average age at death in Woolwich increased from 25 to 64. In the 65 years since 1947 the average age at death in Woolwich has only increased to 72. So much for modern medicine!
The Impact on My Family
The decline in infant mortality meant that women no longer needed to bear a dozen or more children just to ensure that some would survive to become adults. Average family size fell significantly after 1900, which meant that each family had more money for food,medicine and clothing for their children, who grew up healthier as a result.
This can be seen in my family. John and Sarah Brand lived in Saffron Walden in Essex. They were married in 1818 and went on to have five children. Young Sarah was 11 weeks old when she died in 1819; George was four when he died in 1832; Esther was seven when she died in 1839. Henry lived to age 25 before he died in of consumption in 1845. By then, consumption had already taken John. Only Samuel, my great, great grandfather, lived long enough to marry and have children.
Samuel Brand married Mary Ann Roberts in 1850 and went on to have five children before Mary Ann died of consumption in 1863. John died of consumption at the age of seven in 1866. Evelyn died at 15 in 1869. Emma died a month before Evelyn a the age of 18. Two other children, Sarah and Ellen (my great grandmother) lived on into old age.
Ellen Brand married Freddie Hickford in 1880 and went on to have 11 children between 1881 and 1905. Only four died before marrying. Ellen’s youngest daughter, Elsie, my grandmother, married Dick Campbell in 1927. They had only three children who all survived to have families of their own.
Similar stories can be seen in every branch of my family. In most cases my ancestors who survived childhood went on to live very long lives.
Perhaps the most ironic story I can tell is of Lucy Chuter’s two families. I’ve written before about how one was a prosperous middle class family of doctors and the other was a working class family of soldiers, night watchmen and the like. In the family of doctors the average age at death of Lucy’s six grandchildren was just 60. In the other family Lucy’s six grandchildren died at an average age of 81!
