MUNICIPAL HYGIENE. 133 



There can be no doubt that one reason why cities did not grow so 

 rapidly in the seventeenth and eighteenth centuries as in the nine- 

 teenth is the excessively high death rate that prevailed during the 

 earlier period. The flood of immigration, mighty as it was, did little 

 more than make good the places of those citizens who fell victims to 

 grievous sanitary conditions. From the facts that can be obtained it 

 seems to have been universally true that almost up to the beginning of 

 the nineteenth century the death rate of large cities exceeded the birth 

 rate. This was not because the birth rate was abnormally low, but 

 because the death rate was abnormally high. In the medieval city 

 both birth rate and death rate were far higher than at present. Infant 

 mortality must have mounted to a gruesome height. The un- 

 cleanliness and overcrowding of city dwellers, now largely relegated 

 to the slums of our great cities, was the normal state of nearly all 

 classes of society in the London and Paris of Louis and Elizabeth. 

 Mr. Frederick Harrison has condensed into his own vigorous language 

 the annals of many of the historians of the middle ages. 



Tlie old Greek and Roman religion of external cleanness was turned into a 

 sin. The outward and visible sign of sanctity now was to be unclean. No one 

 was clean, but the devout Christian was imutterably foul. The tone of the 

 Middle Ages in the matter of dirt was a form of mental disease. Cooped up in 

 castles and walled cities, with narrow courts and sunless alleys, they would 

 pass day and night in the same clothes, within the same airless, gloomy, window- 

 less, and pestiferous chambers ; they would go to bed without night clothes, and 

 sleep under uncleansed sheepskins and frieze rugs; they would wear the same 

 leather, fur and woolen garments for a lifetime, and even for successive genera- 

 tions; they ate their meals without forks, and covered up the orts with rushes; 

 they flung their refuse out of the window into the street or piled it up in the 

 back-yard; the streets were narrow, unpaved, crooked lanes through which, under 

 the very palace turrets, men and beasts tramped knee-deep in noisome mire. 

 This was at intervals varied with fetid rivulets and open cesspools; every church 

 was crammed with rotting corpses and surrounded with graveyards, sodden with 

 cadaveric liquids, and strewn with disinterred bones. Round these charnel 

 houses and pestiferous churches were piled old decaying wooden houses, their sole 

 air being these deadly exlialations, and their sole water supply being these pol- 

 luted streams or wells dug in this reeking soil. Even in the palaces and castles 

 of the rich the same bestial habits prevailed. Prisoners rotted in noisome 

 dungeons under the banqueting hall; corpses were buried under the floor of the 

 private chapel; scores of soldiers and attendants slept in gangs for months to- 

 gether in the same hall or guard-room where they ate and drank, played and 

 fought. 



The unsanitary conditions thus relentlessly portrayed must have had 

 the same effect upon the health of all town inhabitants that similar 

 conditions now exert upon the denizens of the 'crowded' and 'poor' 

 wards of our modern cities. 



So long as the city death rate exceeded the birth rate, the cities, in 

 spite of the ceaseless thronging in of immigrants, could not grow as 

 they have grown since. The economic equilibrium between town and 

 country probably did not permit of any more considerable transfer of 



