In the Gilded Age people living in most rural areas outside the South were comparatively healthier and lived longer lives, but in the cities the crisis intensified, producing a facsimile of war with a series of epidemic invasions and eruptions as well as a steady annual carnage that took a particular toll on the nation’s infants and children. The diseases came through the air, in the water, and via insects. The losses were not simply an ancient and predictable toll. This was a decline from previous American standards,
