NOTORIOUS SALT MARSHES

The exceptionally high and unstable mortality levels of the marshlands of south-east England have been emphasised continuously throughout this study; their mortal environments have been documented repeatedly using each of the measures of mortality variation (Chapters 3 and 4). These high mortality levels also aroused frequent notice in the period. Almost every writer of south-east England topography dwelt on their unhealthiness (Chapters 1 and 2) and contemporary comments, like the mortality data, sum up time and again the association of a marshland environment and an unhealthy population. Some of these comments have been tabulated for individual south-east England parishes, alongside their burial:baptism ratios, in Table 6.1. The combination of these descriptions of extreme unhealthiness and a high excess of burials over baptisms leaves no doubt that marsh parishes were the most notorious of all black spots during the early modern period. Sheerness was described as ‘the most fever- ridden place in the whole of England’ and the notoriety of the south-east England marshlands was firmly recalled in the old Kentish proverb:

Many observers, moreover, recognised a sharp distinction between the extreme unhealthiness of saline marsh situations and the more favourable environment of other types of marshy places.

AGE AT DEATH ACROSS THE PARISHES OF SOUTH-EAST ENGLAND

Burial:baptism ratios and crude death rates sketch the broad vistas of the contours of death and contours of health of our past. Many historical demographers, however, are no longer content to limit their analysis to such basic indices – there is now a demand for more penetrating statistics describing the structure of mortality and, in particular, its variation by age, sex and season. This chapter looks at mortality patterns across space and time using some of these measures of mortality. The findings reinforce those of the previous chapter and provide us with further clues for an understanding of the epidemiological landscapes of south-east England.

Age-specific mortality rates for the 600 or so parishes across a span of 200 years would be impossible to calculate. But towards the end of the eighteenth century, a number of parish burial registers began to contain some information on the age status of the deceased. For Essex, Kent and East Sussex about 100 parish registers have been found which systematically recorded age at death (in years or years and months) for a reasonable length of time prior to 1812. This material has been supplemented with a small sample of age at death data drawn from the Clergymen's Returns in the 1831 Census.

AIRS, WATERS AND PLACES – LOCAL VARIATIONS IN MORTALITY AND THE SEARCH FOR EXPLANATIONS

The topographers who traversed the English countryside, the physicians who visited the sick, the vicars and parishioners who experienced or watched the toll of disease and dying in their local parishes were acutely aware that life's chances varied according to place. Their perceptions, their descriptions and their crude attempts to quantify such observations have now been matched against our more refined mortality statistics (Figure 5.1). Levels of mortality did vary dramatically across the topographical divides of south-east England and they varied according to the ‘airs’ and ‘waters’ of different ‘places’ in ways that had been clearly recognised since the sixteenth century (Figure 1.1). Some places were notoriously unhealthy, their mortality levels exceptionally high. Other places were refreshingly healthy and their death rates remarkably low. Our statistical analysis shows that infant mortality rates could reach over 300 per 1,000 in one place and remain below 100 per 1,000 in another. Life expectancies at birth may have ranged from 20s to 30s in some parts of the south-east English countryside and, yet, elsewhere, have exceeded forty or even fifty years by the early nineteenth century (Figure 5.1 and Tables 4.1 to 4.6). Autumn could prove unusually mortal to the unhealthy environments and, yet, remain favourable to others (Figure 4.10).

FROM MARSHLAND MALARIA TO A CHRONOLOGY OF EPIDEMIC VISITATIONS

The outstanding feature of the geography of mortality in south-east England has been explained in terms of one predominant disease. Malaria was a disease confined to the marshlands and bounded – both in time and space – by its ecological and biological controls of stagnant waters, a plasmodium parasite and a mosquito vector. Its geographical incidence emphasises the strong and direct association between the environment and the epidemiology of a single disease.

But both within and beyond the marshland zones, many other diseases and epidemics raged throughout this period. Other pockets of elevated mortality also existed elsewhere in south-east England. Some urban centres, in particular, were found to be unhealthy with large annual and seasonal fluctuations of burials, and the demographic findings suggest that low-lying and riverine areas throughout south-east England experienced higher and more unstable mortality series than upland parishes. Areas such as the High Weald, by contrast, appeared to have patterns of unusually low or stable seasonal and annual mortality.

PARISH REGISTERS AND REGIONAL DEMOGRAPHIC STUDIES

The mortality experience of different communities in past times is a central aspect of this regional study. The burial ceremonies of generations of men, women and children are recorded in the Anglican parish registers and in the books of nonconformist meeting houses and these comprise the main quantitative source from which to sketch the contours and outlines of mortality in the parishes of south-east England. The registers for Essex, Kent and Sussex contain many thousands of entries though we know that many others have been missed, lost or obliterated with the passage of time. The burial registers record the final departure of the deceased from this world; they tell us little about the individual, his or her status in life, the cause of death or any intimate details that would help furnish our imagination of past times. For the most part we are left with endless lists of long-forgotten names – bare reminders of all those who ended their days in the little villages and towns of Essex, Kent and Sussex.

‘I'M FEELING UNDER THE WEATHER!’ – THE SEARCH FOR ENVIRONMENTAL ASSOCIATIONS IN TIMES AND PLACES OF DISEASE AND DEATH

The search for associations between disease, death and atmospheric, environmental and geographical influences has fascinated and perplexed physicians and their patients for many thousands of years. For at least five millennia, men and women have observed and recognised that patterns of sickness vary according to locality and season, and that certain attributes of the weather or the environment might be related to fluctuations and variations in ill-health and well-being. Over the centuries, people have expressed these beliefs using such aphorisms as ‘I'm feeling under the weather’ or ‘You'll catch your death of cold’, while the sick might be recommended to try ‘a change of air’ or a trip to the spas and seaside to ‘take the waters’ and ‘breathe in the ozone’. The airs and waters of the earth have been viewed both as a source of disease and as a therapy for the sick.

THE BOUNDS OF MALARIA – FROM ‘BAD AIR’ TO MARSHLAND MALARIA

The most outstanding epidemiological divide within south-east England was not between rural and urban communities but along the bounds of marshland and non-marshland terrain. It was here that the natural environmental or ecological features proved to be the critical determinants of the patterning of disease and death. In the area of marshland topography and ‘bad airs’, the seventeenth- and eighteenth-century writers had written with remarkable clarity and perception. They had sensed with their noses, they had realised through their experiences and their ill health that some unique and peculiar quality of the marsh air gave rise to frequent suffering and premature death. The belief that it was the ‘mal'aria’ of the marshes which caused the high levels of mortality and sickness was not, of course, strictly correct. It was not the ‘bad air’, per se, that contributed to marshland mortality. Rather it was an anopheline mosquito vector, capable of transmitting a parasitic disease to humans, that was the culprit in this mortal landscape. Seventeenth-and eighteenth-century men, women and children were observing, witnessing and falling victim to the true plasmodium malaria. But they were unaware of the real ecological and biological parameters of this disease.

In reconstructing the demographic and epidemiological landscapes of early modern south-east England, considerable attention has been given to the role of malaria in this setting (Chapter 6).