Contours of death : disease, mortality and the environment in early modern England

Abstract

Interest in health and the environment dates back many thousands of years and is particularly associated with the Hippocratic works, On Airs, Waters and Places. The seventeenth and eighteenth centuries saw a resurgence of Hippocratic ideas. Physicians and topographers began to collect sets of medical and environmental observations and to ask why diseases varied according to locality or season, why certain environments seemed more conducive to ill-health than others, and, in turn, whether such knowledge could be used to intervene, ameliorate, manage or avoid unhealthy sites. This paper seeks to readdress these environmental issues using the tools and techniques of historical demography and a multifactorial approach. Mortality and epidemiological data from a very large number of parishes in Southeast England are analysed, as a way of understanding the influence of 'airs, waters and places' on early modern populations. The paper concludes that features of the natural environment accounted for some of the spatial variations in disease and mortality, but many epidemiological patterns were far more complex, reflecting the significance of a range of environmental, social, economic, biological and demographic variables. In trying to reconstruct past epidemiological landscapes, it is now time to ‘move beyond the real wage’, to move beyond ‘airs, waters and places’, and to avoid the temptation to search for any single determinant of mortality patterns and their changes over time and space