A bar of faith and hope

一个信念和希望的酒吧（这里bar也许不是酒吧的意思，但是看英英释义想不出其他的词）

By the 18th century the first stirrings of a more systematic approach to public health began to appear. Larger cities established public bodies charged with determining when and how to conduct quarantines in response to outbreaks of diseases like smallpox. Many set up hospitals to care for the ill. But it was the beginning of industrialisation, and the associated growth of cities, that proved the most consequential health development of the century.

到了18世纪，一种更系统的公共卫生方法开始出现。大城市设立了公共机构，负责确定何时以及如何对天花等疾病的爆发进行隔离。许多人建立了医院来照顾病人。但事实证明，本世纪最重要的健康发展，是工业化的开始和随之而来的城市增长。

词汇

Smallpox/天花

London’s population roughly doubled in the 18th century, to about 1m inhabitants. It then rose nearly sevenfold in the 19th. That of New York City grew from about 30,000 people to 3.5m between 1790 and 1900. Manufacturing centres across Europe and North America transformed from modest villages to swelling metropolises in the space of a lifetime.

伦敦的人口在18世纪大约翻了一番，达到约100万。19世纪，这一数字增长了近7倍。纽约市的人口从1790年的3万增长到1900年的350万。欧洲和北美的制造业中心，在一眨眼的时间里，就从不起眼的村庄变成了蓬勃发展的大都市。

词汇

Sevenfold/七倍的；七重的

Swelling/肿胀，肿块；膨胀

Metropolis/大都市；首府；重要中心

The consequences for public health were devastating. Factories pumped smoke into the air. Sewers emptied waste into rivers and lakes used for drinking water. Epidemics of water-borne diseases like cholera and typhoid killed thousands of people. As a result, death rates in cities were substantially higher than those in rural areas. They were also higher than the urban birth rate. In the early 19th century, as many as half of the children born to the working class in London died by the age of five. Only the steady flow of people migrating from the countryside kept cities from shrinking.

（而工业化）对公众健康的影响是毁灭性的。工厂向空气中排放烟雾。下水道把废物排入用于饮用的河流和湖泊。霍乱和伤寒等由水传播的疾病导致成千上万人死亡。因此，城市的死亡率大大高于农村地区。（死亡率）也高于城市人口的出生率。19世纪初，伦敦工人阶级出生的孩子中，有多达一半在五岁前就夭折了。只有农村稳定的人口流动才使城市免于萎缩。

词汇

Sewer/下水道；阴沟

Cholera/霍乱

Typhoid/伤寒

The hardship of city life during the first century of industrialisation fed the deep discontent with capitalism brewing among the working classes. Friedrich Engels, in his writing on “The Condition of the Working Class in England” (1845), made much of the state of sanitation in the districts occupied by poor labourers, like St Giles in London, where “heaps of garbage and ashes lie in all directions, and the foul liquids emptied before the doors gather in stinking pools.”

工业化的第一个世纪，城市生活的艰辛助长了工人阶级对资本主义酝酿的深深的不满。弗里德里希·恩格斯在他写在“英国工人阶级的状况”(1845)的国家的卫生区被贫穷劳动者,像在伦敦圣吉尔斯,“成堆的垃圾和灰烬铺的一地都是,污浊的液体倒在门口聚集成臭气熏天的池。”

词汇

Brewing/酿造；酝酿；计划

Heap/堆；许多；累积

Stinking/发恶臭的

But dirt posed a greater threat to the sustainability of capitalist growth than socialist thinkers did. High urban mortality rates placed a ceiling on the extent to which early industrial societies could urbanise, of about 30%—or roughly the share of the population of the Netherlands considered urban in the 18th century. The deadliness of industrial cities became a bottleneck to modern economic growth.

但污染对资本主义增长的可持续性构成的威胁，比社会主义思想家们所认为的要大。高的城市死亡率为早期工业社会城市化的程度设定了上限，约为30%——大约相当于18世纪荷兰被认为是城市人口的比例。工业城市的致死率成为现代经济增长的瓶颈。

 

Such terrible conditions slowly moved people to demand action. Nascent studies on chronic infectious disease made clear that cities themselves were deleterious to health, though the best minds of the day could not be certain precisely why. This was no small problem. The rapid pace of change within cities, and the sheer number of sources of nastiness which might contribute to ill health, made the problem of spurious correlation nearly insurmountable.

如此恶劣的环境慢慢地促使人们要求采取行动。对慢性传染病的初步研究表明，城市本身对健康有害，尽管当时最聪明的人也不能确切地确定原因。这不是一个小问题。城市内部变化的速度之快，以及可能导致健康不健康的污秽来源之多，使得虚假关联的问题几乎无法克服。

词汇

Nascent/新兴的，初期的

Deleterious/有毒的，有害的

Nastiness/不洁，污秽

Spurious/假的；伪造的；欺骗的

Some 18th-century scholars speculated that ailments might pass from person to person through the movement of unknown microscopic particles. In the absence of the equipment and know-how needed to detect such particles, empirically serious scholars dismissed the notion in favour of the idea that miasma, or foul air, was the cause of infectious disease. The theory found further favour with businessmen who disliked the trade-interrupting effects of quarantines and reformers keen to clean up the cities.

一些18世纪的学者推测，疾病可能通过未知的微小颗粒在人与人之间传播。在缺乏检测这些粒子所需的设备和专业知识的情况下，严肃的经验学者们摒弃了这种观点，转而支持瘴气或污浊的空气是传染病的原因的观点。这一理论得到了不喜欢隔离造成的贸易中断的商人和热衷于清理城市的改革者的进一步支持。

词汇

Ailment/小病；不安

Empirically/以经验为主地

Miasma/瘴气；臭气；不良影响

In the 19th century scores of public-minded individuals began pitching schemes to clean up cities. Edwin Chadwick, a British lawyer who contributed to the reform of the English Poor Laws, oversaw the drafting of a scathing report on sanitary conditions in Britain, published in 1842, which documented that the average age of death for tradesmen in London was just 22, and for labourers just 16. Chadwick cited miasma as the chief contributor to infectious illness and called for large-scale public investments in drainage and sewage systems. Similar figures across the industrialising world sought to build support for policies to clean up deadly cities. Dickens was one of them.

在19世纪，许多有公德心的人开始兜售清洁城市的计划。英国律师埃德温•查德威克(Edwin Chadwick)为英国穷人法的改革做出了贡献，他监督起草了一份关于英国卫生状况的措辞严厉的报告，该报告于1842年发表，记录了伦敦商人的平均死亡年龄只有22岁，劳工的平均死亡年龄只有16岁。查德威克指出瘴气是导致传染病的主要原因，并呼吁对排水和污水系统进行大规模的公共投资。在整个工业化世界，类似的数据试图为清理致命城市的政策寻求支持。狄更斯就是其中之一。

 

It was not easy. Despite reports such as Chadwick’s, scientific understanding remained scant. In 1849 The Economist declared that:

这并不容易。尽管有诸如查德威克的报告，科学的理解仍然很少。在《经济学人》子刊物《1849》，记录道：

The belief in contagion, like the belief in astrology and witchcraft, seems destined to die out; and as we have got rid of all regulations for consulting the starts or attending to omens before we begin any undertakings, and of all the laws against feeding evil spirits and punishing witches, so we shall no doubt in time get rid of the quarantine regulations that were established from the old belief in contagion.

对传染病的信念，就像对占星术和巫术的信念一样，似乎注定要消亡;我们开辟任何新的事业已经摆脱了挑选黄道吉日或是祈求一些征兆；或是对投喂恶灵，鞭挞女巫的的法则置之于外。毫无疑问，我们已经处于摆脱关于传染病的种种“规则”时期，那种先前基于传染病时期的老旧信念。

词汇

Contagion/传染病

Astrology/占星术；占星学

Witchcraft/  巫术；魔法

die out/灭绝；消失

omen/ 预兆；征兆

So too did stubborn citizens grow weary of the lecturing of muckraking do-gooders. By 1854, outbreaks of infectious disease had killed thousands of Londoners of all classes, and yet an editorial in The Times huffed, “We prefer to take our chance of cholera and the rest rather than be bullied into health.”

同样，顽固的公民也对那些揭露黑暗面的行善者的说教感到厌倦。到1854年，传染病的爆发夺去了成千上万的伦敦人的生命，而《泰晤士报》的一篇社论愤怒地写道，“我们宁愿冒霍乱和其他疾病的险，也不愿被逼走向健康。”

词汇

Weary/疲倦的；厌烦的

Muckraking/收集并揭发名人丑闻

Huff/  生气地说

Instead the concept of a collective responsibility to invest in public goods had to be cultivated. As Johan Goudsblom, a Dutch sociologist, noted: “Increasingly, it dawned upon the rich that they could not ignore the plight of the poor; the proximity of gold coast and slum was too close.” Governments at all levels began to take on direct responsibility for tidying up large cities. Removal of household waste, cleaning of streets, provision of fresh running water and universal connection to sewage slowly became the norm.

相反，必须培养投资于公共产品的集体责任的概念。正如荷兰社会学家约翰•古兹布卢姆(Johan Goudsblom)指出的那样:“富人越来越意识到，他们不能忽视穷人的困境;黄金海岸和贫民窟太近了。“各级政府开始直接担负起清理大城市的责任。清除生活垃圾、清洁街道、提供新鲜自来水和普及污水处理逐渐成为一种规范。

词汇

Plight/困境；境况

Sewage/污水；下水道

The effects of this sanitary revolution were dramatic. Though data from the late 18th and early 19th centuries are patchy and flawed, the broad picture is clear. Across industrialising cities, mortality rates, for the young especially, held steady at high levels or climbed slightly in the early 19th century, as rapid urbanisation unfolded, despite a dramatic decline in smallpox mortality over this period associated with the rise of inoculation. From around 1840, however, a trend toward declining mortality rates began to take hold. Life expectancy at birth rose about 6 years, on average, across large British cities from 1838 to the end of the century. In Paris it rose by about ten years over this period; in Stockholm by roughly 20. In America the crude death rate per 1,000 people rose in New York City from about 25 in the early 1800s to roughly 35 in 1850, before falling to near 20 by the end of the century. Trends in other large American cities were similar.

这次卫生革命的影响是巨大的。尽管18世纪末和19世纪初的数据是零碎的、有缺陷的，但总体情况是清楚的。在工业化的城市中，死亡率，尤其是年轻人，在19世纪早期，随着快速城市化的展开，保持在高水平，或略有上升，尽管在这一时期，随着接种的增加，天花死亡率急剧下降。然而，从1840年左右开始，死亡率开始下降。从1838年到本世纪末，英国各大城市的平均预期寿命增加了约6岁。在巴黎，这一时期上升了10年;在斯德哥尔摩大约是20。在美国，纽约市每千人的粗死亡率从19世纪初的约25人上升到1850年的约35人，到本世纪末降至近20人。美国其他大城市的趋势也类似。

词汇

Sanitary/卫生的

Mortality/死亡率

Inoculation/  [医] 接种