By modern standards, hygiene was horrific because people did not connect cleanliness with health, and bathing was even considered dangerous. Clean clothes signified a dandy or a rich man, while laborers often took pride in the stains of their trade and wore them for a season without removing them. Diseases now completely controlled routinely swept across the land and killed thousands; in 1839, for every person who died of old age or violence, eight died of specific diseases. In Albany and Pittsburgh, water sanitation made it possible to fight epidemics, helping launch broader campaigns for hygiene. The struggle against epidemic disease was won more through sanitation than medication, and later evidence has shown a relationship between infant mortality and the consumption of soap. Cleanliness and medical standards reflected the resources and practices of the time, and workers or travelers might be away from home for weeks or months.