期刊名称：Discussion Papers in Economic and Social History / Oxford University
出版年度：2010
卷号：2010
出版社：Oxford
摘要：Medical knowledge – defined broadly to include both its private and public forms –
has been the driving force behind the historical transitions that have raised life
expectancy in modern Europe. Advances in knowledge, rather than better nutrition
(particularly the escape from caloric insufficiency) deserve greater emphasis because
the very first groups to undergo anything recognizable as a secular rise in longevity
were the rich and well fed, rather than the poor and chronically malnourished. At the
beginning of the 16th
century Europe’s ruling elites lacked virtually any reliable
information about how best to use their ample material resources to prevent, manage
and cure the ill-health that caused so many premature deaths among them. The
advance of medical knowledge and practice accelerated in Western Europe after c.
1500, with a succession of discoveries that were quite useful (as judged by modern
standards) in preventing disease, reducing “life-style” risks, managing illness and
providing cures for a few debilitating and deadly diseases – severe dysentery,
syphilis, malaria, scurvy and, finally, smallpox, being the principal diseases affected.
Yet, access to most of the available innovative medical care remained closely
restricted. Medical expertise was limited and highly priced, and many of the measures
prescribed were unaffordable even to town-dwelling middling-income families in
environments that exposed them to endemic and epidemic disease. Along with the
poor, they therefore were left at a grave health disadvantage vis-à-vis adult members
of the wealthy urban families to whose conditions the doctors were attending. The
London-based ruling families of England in this epoch benefited to an exceptional
degree among the European elites from the contemporary progress of medicine. Their
improved chances of survival in adulthood were the major factor raising royal life
expectancy at birth (males and females, combined) from 24.7 years for the cohort
born during the 1600s to 49.4 years for those born during the 1700s.
