Epidemiology in country practice

techniques and methodology it has vindicated the parish registers as the prime pre-census record of English demography after two generations of growing doubts about their flaws. Only the very highest technical sophistication has allowed this to be done and the harvest of further "reconstitutions" is yet to come. Relatively little space, and much less technical sophistication, has gone into the sections of the text which seek to relate demographic mechanisms to their economic, social, and cultural contexts. The principal exercises undertaken are to establish the correlations with the Phelps Brown national indexes of builders' wages and prices (now rather elderly and frail survivors from the 1950s). These reveal that population pressure pushed up food prices (the positive correlation only being broken after the Napoleonic Wars); that rapid population growth had an adverse effect upon real wages until after 1801; and that marriage rates, with gross reproduction rates and cohort reproduction rates, moved with real wages (the latter only after considerable time-lags). The Phelps Brown indexes are too crude to bear much weight of this sort (particularly given the time lags of 15-65 years built into the correlations) and this sort of relationship of the demographic variables to context cries out for detailed regional and local analysis. With such deep-seated regional variations in all the relevant parameters in eighteenth-century England (including variations in the rates of population growth), national indexes mask much of the reality and do not prove the best basis for analysis. Consequently, social and economic historians, including historians of medicine, who are particularly concerned with the interrelations between demographic change and its context, will not find many answers to their questions here. Death rates and mortality variations are little regarded: correlations with wheat prices and real wages are poor, which suggests that disease was the main marginal determinant. Short-run fluctuations in death rates were "very largely determined by variations in factors. . . amongst which those determining the prevalence of lethal micro-organisms, though multiform and for the most part unobservable, may have been the most significant" (p. 354). But little is said in any detail, particularly once the "dismal peaks" produced by main surges of epidemic disease had faded after 1727-30. Again, regional analysis is awaited and the absence of London from the parishes chosen for the sample must be influential in this regard. Inoculation and vaccination, medicine, hospitals, etc., do not feature in the index. Nor (more surprisingly, perhaps) is there any discussion on the fertility side of the demographic equation of limitation of births within marriage (which was the subject of a famous article by Professor Wrigley in 1966). For historians of medicine, therefore, this most important volume does not answer many of their questions but it does establish a large agenda for them. Peter Mathias All Souls College, Oxford