The main causes of the poor quality of urban life — deadly overcrowding, pervasive poverty, and lack of medical knowledge — had existed for centuries. Packed together almost as tightly as possible, people in cities suffered and died from the spread of infectious disease in far greater numbers than their rural counterparts. In the larger towns, more people died each year than were born, on average, and urban populations maintained their numbers only because newcomers continually arrived from rural areas.

The Industrial Revolution exacerbated these deplorable conditions. The steam engine freed industrialists from dependence on the energy of fast-flowing streams and rivers so that, by 1800, there was every incentive to build new factories in urban areas, which had many advantages. Cities had better shipping facilities than the countryside and thus better supplies of coal and raw materials. Cities had many hands wanting work. And it was a great advantage for a manufacturer to have other factories nearby to supply the business’s needs and buy its products. Therefore, as industry grew, already overcrowded and unhealthy cities expanded rapidly.

Great Britain, the first country in the world to go through the early stages of the Industrial Revolution (see Chapter 20), was forced to face the acute challenges of a changing urban environment early on (Map 22.1). Except on the outskirts, early-nineteenth-century cities in Britain used every scrap of available land to the fullest extent. Parks and open areas were almost nonexistent. Developers erected buildings on the smallest possible lots in order to pack the maximum number of people into a given space.

These highly concentrated urban populations lived in extremely unsanitary and unhealthy conditions. Open drains and sewers flowed alongside or down the middle of unpaved streets. Toilet facilities were extremely primitive and inadequate. In parts of Manchester, as many as two hundred people shared a single outhouse. Such privies filled up rapidly, and since they were infrequently emptied, sewage often overflowed and seeped into cellar dwellings. By the 1840s there was among the better-off classes a growing, shocking “realization that,” as one scholar put it, “millions of English men, women, and children were living in shit.”1

The environmental costs of rapid urbanization and industrialization were enormous as well. Black soot from coal-fired factories and train engines fouled city air, and by 1850 the River Thames was little better than an open sewer.

Who or what bore responsibility for these awful conditions? The crucial factors included the tremendous pressure of more people and the total absence of public transportation. People simply had to jam themselves together to get to shops and factories on foot. In addition, government in Great Britain, both local and national, only slowly established sanitary facilities and adequate building codes.

Most responsible of all was the sad legacy of rural housing conditions in preindustrial society combined with appalling ignorance of germs and basic hygiene. When ordinary people moved to the city, housing was far down on their list of priorities, and they generally took dirt for granted.