Abstract
In their article ‘An Interpretation of the Modern Rise of Population in Europe’ published in Population Studies, 26, 3, McKeown, Brown and Record conclude that European ‘population growth was not influenced by improved sanitation before about 1870 or by specific medical measures before the introduction ofthe sulphonamides in 1935’.The authors go ootoargue that population increase before the twentieth century was essentially doe ‘to a decline of mortality which resulted from improvement of diet ... (through) a large increase of food production’. The present article consists of a critique of these arguments based on a detailed examination of evidence forEngland oodWales. From u review of the demographic evidence and that on food supply and consumption per head it is concluded that population expansion could not have been due to an improvement in diet during the relevant period. Two hypotheses are put forward to account for the increase in population in England and Wales: (1) a reduction in smallpox mortality through the use of inoculation during the eighteenth century; (2) a reduction in mortality from dirt diseases such as gastro-enteritis, typhoid fever, dysentery, relapsing and trench fever, and typhus, due to an improvement in personal hygiene (measured by the consumption of soap and washable cotton goods) during the first 40 years of the nineteenth century.

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