Rad Geek People's Daily

Reading: William H. McNeill, Plagues and Peoples, Chapter VI, The Ecological Impact of Medical Science and Organization Since 1700

The usual Over My Shoulder rules apply:

1. Avoid commentary above and beyond a couple sentences, which should be more a matter of context-setting or a sort of caption for the text than they are a matter of discussing the material.

2. Quoting a passage absolutely does not entail endorsement of what's said in it. You may agree or you may not. Whether you do isn't really the point of the exercise anyway.

Anyway, here’s the quote. This is from Chapter VI, The Ecological Impact of Medical Science and Organization Since 1700, in William H. McNeill’s Plagues and Peoples (1976/1998). Like a lot of the work it’s a resolutely Malthusian exploration, and I think is both very usefully insightful and also of course a lot of wild oversimplification. But I marked it off as interesting because of the reflection on a changing relationship between town and country — not the fact of a division, which is as old as cities, but a shift in the terms of that division, and one possible sort of impact not only on the relationship between the two but on the endogenous development of cities themselves.

Chapter VI.

. . . Obviously, there was always a considerable lag between decision to introduce improved water and sewage systems and the completion of necessary engineering work. But by the end of the nineteenth century all major cities of the western world had done something to come up to the new level of sanitation and water management that had been pioneered in Great Britain, 1848-54. Urban life became far safer from disease than ever before as a result. Not merely cholera and typhoid but a host of less serious water-borne infections were reduced sharply. One of the major causes of infant mortality thereby trailed off towards statistical insignificance.

In Asia, Africa, and Latin America, cities seldom were capable of making sanitary water and sewage systems available to all the population; yet even there, as the risks of contaminated water became more widely known, simple precautions, like boiling drinking water, and periodical testing of water supplies for bacteriological contamination, introduced a quite effective guard against wholesale exposure to water-borne infections. Administrative systems were not always capable of sustaining an effective bacteriological watch, of course; and enforcement was even more difficult in many situations. But means and knowledge needed to escape large-scale outbreaks of lethal disease became almost universal. Indeed, when local epidemics of cholera or some other killing disease occurred, it soon became common for richer countries to finance international mobilization of medical experts to help local authorities in bringing the outbreak under control. Hence even in cities where a water-sewage circulatory system had never been installed, some of the benefits of public sanitation were swiftly brought to bear.

By 1900, therefore, for the first time since cities had come into existence almost five thousand years previously, the world’s urban populations became capable of maintaining themselves and even increasing in numbers without depending on in-migration from the countryside.^[66] This was a fundamental change in age-old demographic relationships. Until the nineteenth century, cities had everywhere been population [pg]280[/pg] sumps, incapable of maintaining themselves without constant replenishment from a healthier countryside. It has been calculated, for example, that during the eighteenth century, when London’s Bills of Mortality permit reasonably accurate accountancy, deaths exceeded births by an average of 6,000 per annum. In the course of the century, London therefore required no less than 600,000 in-migrants for its mere maintenance. An even larger number of in-migrants was needed to permit the population increase that was a conspicuous feature of the city’s eighteenth-century history.^[67]

Implications of this change are profound. As cities became capable of sustaining growing populations, older patterns of migration from rural to urban modes of life met new obstacles. Rural in-migrants had to compete with a more abundant, more thoroughly acculturated population of city-born individuals, capable of performing functions formerly relegated to newcomers from the countryside. Social mobility thereby became more difficult than in times when systematic urban die-off opened niches in the cities of the world for upwardly mobile individuals coming in from rural backgrounds. To be sure, in regions where industrial and commercial development proceeded rapidly, this new relation between country and city was masked by the fact that so many new occupations opened in urban contexts that there was room for city-born and rural in-migrants alike. In regions where industrialization has lagged, on the other hand, the problem of social mobility has already assumed visible form. In Latin America and Africa, for example, vast fringes of semi-rural slums commonly surround well-established cities. These are squatting grounds for migrants from the countryside who are seeking to become urban, yet cannot find suitable employment and so must eke out a marginal existence amid the most squalid poverty. Such settlements give visible form to the collision between traditional patterns of migration from the countryside and an urban population that no longer, as aforetime, withers away so as to accommodate the newcomers crowding at the gate.

— William H. McNeill (1976)
Plagues and Peoples, 279-280.

1. ^[66]In Cairo, Egypt, for example, the birth rate was 44.1 per thousand, the death rate only 36.9 per thousand in 1913, the year before a modern sewage system was inaugurated in part of the city. Cf. Robert Tignor, Public Health Administration in Egypt under British Rule, 1882-1914 (Unpublished Ph.D. thesis, Yale University, 1960), pp. 115-21.↩
2. ^[67]C. Fraser Brockington, World Health, 2nd ed. (Boston, 1968), p. 99.↩