There’s an old saying that goes, “The rate of death has not changed since the days of the Bubonic Plague. It’s still one per person.”
What has changed, and most dramatically, is people’s attitudes to death and they way it is dealt with. Many writers forget that penicillin (that is, antibiotics) weren’t in common use until 1945 and there was a war on then, so many ordinary people still didn’t know about them, or had no access to them. Germ theory wasn’t proven until 1905 and even after that many people refused to believe something they couldn’t see could make them ill.
Therefore death was common and expected. Most families, even in the early twentieth century, had a child who died from measles, or influenza or diarrhea. One hundred years earlier, one quarter of all teenage brides still died in childbirth, and most women were married before they were twenty. Families did not mourn their children any less than a family does now, but death was expected, considered a part of life. Death was a fellow-traveler, always present and as likely to strike from a simple infected cut as from cholera or typhoid—diseases which appeared regularly with droughts and floods.
Any historical novel needs to accurately reflect this situation and the attitudes of those times. Today’s treatment of diseases, death and dying, are totally different from those of last century. Every time I read about a heroine washing the wound, pouring alcohol over it to cleanse it, then carefully sterilizing her needle before sewing up the wound, I shake my head. No, no, and no. A village wise woman may have learned that cleaning a wound helped it heal, but the local water supply was probably full of germs, alcohol was more likely to be forced down the victim’s throat to help them bear the pain, and the wound may have been covered with moss, or spider webs, or a dirty piece of old fabric.