BMJ Publishing Group

History: Two Hundred Years since Malthus

Author(s): John A. Black
Reviewed work(s):
Source: BMJ: British Medical Journal, Vol. 315, No. 7123 (Dec. 20 - 27, 1997), pp. 1686-1689
Published by: BMJ Publishing Group
Stable URL: http://www.jstor.org/stable/25176579 .
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Education

and debate

come
across
I have
in which
instance
only
to reassure
voices
the patient
of
sought
in her welfare,
interest
her a spe
offered
no clinical
that would
(there were
signs

and

the first

hallucinatory
their genuine
cific

diagnosis
alerted

have

type of hospital

attended

the

various

was

split

of

to her

two well

from

a brain

tumour

treated

in her

she had made

original
the NHS.

under

free

up

the convoluted

was

and

to NHS

entitled

History
Two hundred

treatment

she

Besides,

were
'

had

fear

voices.

She

who
the

that,

it was
absolutely
felt
have
that

suggested

and

this

funny
of

experience

have

may

unconsciously
various
hospitals
was
reproduced

about
information

of

part
voices

to her

led

information

as

The

the

of

disappearance
of
removal

to

they surmised,
tale about
voices
tell-

They

to

hallucinatory
auditory
with
the
satisfaction
expressing
were her own mind
of her treatment
express
was over. And
its relief
the total
that the emergency

ing

and wanted

That

mind

experience.
outcome

formulation.

Hence,

was

must

"She

patient

argued.

she realised,
her

by

ing her this and that But AB had lived in Britain for 15
years

than

telepathic
who
people

country

they

conference

notwithstanding,
signs
of that size had had

the

hallucinatory
in more
taken

of

different

on

disappeared

on holiday

view

Their

opinion.

physical
a tumour

that

tumour.

brain

to them, AB had been given the diagnosis of

According
be

a very

of

something,"

experience.
who
People

meaning

first

the voices

feeling in her head had led her to fear that she had a

that AB had a tumour and

had

X-phobes

instance

clear

lack

unlikely
no
effect

today rejoiced that what had

was

a different

total

that year.

when

that she had gone

of her
the recovery
sanity.
was
a group
at the case

There

by several

her

aspects
down
the middle.

had, psychically, found

sought to help her.
The

later

thioridazine

offered

for her, bid her

disappeared.
at a conference

would be called X-philes

happened
communication

last

had

and was closely questioned

about

people
The
audience

at

she

they desired

case

her

presented

her

that

pleasure

thereafter

and

farewell,

to deal with

been

on

celebrate

to the

her

directed

tumour),

equipped

the treatment

received

AB

best

expressed

problem,

to the

anyone

so relieved

had

at

the

least

related
direcdy
in
fact, have
may,

lesion-and
lesion

itself.

consent

to

I have

after

symptoms
that these

psychiatric
tumour
showed
to

the

presence

been

obtained

symptoms
of the
the

by

produced

the

the

signed

patient's

publication.

years since Malthus

John A Black
Victoria Mill House,
Framlingham,
Woodbridge,
Suffolk IP13 9EG
John A Black,
retired consultant
paediatrician
BMJ 1997;315:1686-9

was

a mathematician
by
training
a teacher
of political
economy,

Malthus
profession

and
by
his work

but

was greatly influenced by his Christian convictions. In

the first edition of his Essay, published in 1798, he put
forward the hypothesis that population, if unchecked,
would increase by geometrical ratio, doubling itself
every 25 years, while food supply could increase by
arithmetical

only
was controlled
and

ratio.
by

He

that

suggested
such
checks"

"positive

population
as war, famine,

elected fellow of the college in 1797, and four years

later took Holy Orders. In 1805 he was appointed
of

professor

at

economy

political

the

in

death

from

1834

(fig 2). He married

of

"disease

heart"

the

in Bath

at the age of 38 and had

three

children.

disease.
He

campaigned
of
the

abolition

old

unsuccessfully
laws
poor

for
which,

the

gradual

he

thought,
to
and

to marry
class
the
young
encouraged
working
In his second
edition
he introduced
have
large families.
of
the
the
checks"
concept
by moral
"preventive
restraint?late

and

marriage

restraint

within

marriage.

The reduction in fertility which Malthus advocated was

of birth

achieved

by the acceptance
He was
violently
opposed.
and has been misinterpreted
lifetime
ever since.
stood

he was

control,
attacked
and

to which
during
misunder

his

to

checks

Positive

on

was

born

seem

14 February
a cleft
with

to have

entered

mathematics,

hindered

Jesus

tide

was

as

it

With

"An

essay
the

affects
remarks

Condorcet,
He

(known as Robert)

(fig 1)was

near

Dorking,
Surrey. He
not
does
but
this
and
lip
palate,
career.
In 1785
his academic

College,

obtaining

for

enthusiasm
de

Marquis

the
and

Condorcet

set out

on

the

of
principle
population
of
society.
improvement
Mr. Goodwin,
of
speculations

future

on

the

and

other

writers."1

of
"The power
popula
clearly:
to
in the earth
than the power
when
for man.
Population
in a
ratio.
Subsist
geometrical
...
ratio
in arithmetical
By that law

views

his

is infinitely
greater
subsistence
produce
increases
unchecked,

Thomas Robert Malthus

born

father's

the

William Godwin, Malthus published the first edition of

his "essay" as a long pamphlet in 1798 (fig 3). Its full

M.

career

Academic

population

his

against
of
ideas

Reacting
Utopian

tion

he

and

history

newly founded College of the East India Company, at

in Hertfordshire
and
(now Haileybury
Haileybury,
his
He
held
this
until
Service
post
College).
Imperial

1766

Cambridge,
a first
class

ence
of our
man,
kept

increases
nature

only
which

the effects
equal.

This

check

where

he

read

ating

degree.

He

was

subsistence."

of

makes
these

implies

food

unequal
a strong
and

on population

1686

necessary

two

BMJ VOLUME

from

315

to the

powers
constandy

life of

must

be
oper

the difficulty

20-27 DECEMBER

of

1997

Education

He

defined
to

checks

the

as

checks
are

population

follows:

"The

various

extremely
be enumerated

positive
... Under

SACREDTO THE MEMORY

OF

all unwhole
this head,
therefore,
may
severe
to the
some
and exposure
labour
occupations,
extreme
bad
of
seasons,
children,
poverty,
nursing
excesses
of all kinds,
the whole
train of
towns,
great
common

diseases

and

wars,

epidemics,

Wht &eb.

and

plague

famines."

the pressure
[the poor]

can

ingenuity
evidence

that

reach

population
noted
that,

... the
population
a century
for above

America
itself,
than

every
ratio."

means

of

of

question
to human

favourable

to increase

food

under

faster

to double

in less
successively
be
safely
pronounced
on
unchecked,
goes

when

years,

twenty-five

subsistence,

found

been

a half

It may

population,

itself

geometrical
the
On

the

has
and

the
provided
in
geometrical
states
northern
of

increase

"In

....

years

twenty-five
that
therefore,
doubling

America

could

ratio. Malthus

made

it" North

or

he
supply,
circumstances

the most

not
could
be
industry,
possibly
ratio."
than in an arithmetical

Died

Dec. 1834.

29

Fig 2 Memorial to Malthus in Bath Abbey. (From The Malthusian

population theory by G F McCleary. London: Faber and Faber, 1953.)

in
and Russia
Scandinavia,
Germany,
in 1802, accumulat
and Switzerland
was
into the second
which
incorporated
ing material,
own
in 1803,
under
his
name.2
edition,
published
and

France

the
Significandy,
and
past
present
inquiry
removal

Born 14thFeb. 1766.

visited

Malthus
1799

THE SPOTLESSINTEGRITYOF HIS PRINCIPLES

THE EQUITY AND CANDOUROF HIS NATURE,
HIS SWEETNESS
OF TEMPER, URBANITYOF MANNERS,
AND TENDERNESSOF HEART,
HIS BENEVOLENCEAND HIS PIETY,
ARE THE STILLDEARER RECOLLECTIONS
OF HIS FAMILY
AND FRIENDS

"the

wrote:

checks

Preventive

HIS WRITINGSWILL BE A LASTINGMONUMENT

OF THE EXTENTAND CORRECTNESS
OF HI8 UNDERSTANDING.

in a

increases

iWalt&u*

ONE OF THE BESTMEN AND TRUEST PHILOSOPHERS

OF A'NY AGE OR COUNTRY,
RAISED BY NATIVE DIGNITY OF MIND
ABOVE THE MISREPRESENTATIONS
OF THE IGNORANT
AND THE NEGLECT OF THE GREAT,
HE LIVED A SERENEAND HAPPY LIFE
DEVOTED TO THE PURSUITAND COMMUNICATION
OF TRUTH,
SUPPORTEDBY A CALM BUT FIRM CONVICTIONOF THE
USEFULNESSOF HIS LABOURS,
CONTENTWITH THE APPROBATIONOF THE WISE AND GOOD.

"The truth is, that

views, he wrote:
on
this part
of a community
of distress
that no human
is an evil so deeply
seated
his

Summarising

gfl&otna*Robert

LONGKNOWNTO THE LETTEREDWORLD

BY HIS ADMIRABLEWRITINGS ON THE SOCIALBRANCHESOF
POLITICALECONOMY,
PARTICULARLYBY HI8 'ESSAYON POPULATION'.

into
or

subtitie

was

effects

on

our

mitigation

to "Or a view

altered
human

happiness,

prospects
respecting
of the evils which

of

with
the

its
an

future

it occasions."

now

Appreciating

that

led solely by positive

control

the

divided
them
checks." He
"preventive
from
"vice"
and
"moral
restraint,"
arising
he meant
restraint
from
chaste
marriage?that

which

is, late marriage

within

restraint

were:

violations

acts

to

of

conceal

connexions."
lost

sexual
previous
with
voluntary
Preventive

"Promiscuous

sions,

and

without

marriage,
of children.

the number

had

not

introduced

of

concept
those

vice

was

population

checks, Malthus

the
the

According
their
self respect
more

producing

and

liaisons,

and

consequences
to Malthus,
and were
children

pas

improper

of
the

of
from

arising
unnatural

bed,

marriage

by

restriction

checks

intercourse,

into

irregular
orders"

"lower

young
could

marrying
than
they

support

Malthus's

solution

Malthus

advocated

laws with
ing the
"the fear

gradual
undue
against

safeguards
threat of economic
of want,
to

stimulus
In

the

spite

cannot

industry."
of this approach

has

is born
get

labour,
food,

just
has
and,

in fact, has

the
but

distress,

poor
retain

he

was

able

from
and
of
no

to write

(not in the sixth edition):

a world

into

subsistence
demand,
no claim

of

He
that
thought
hardship.
than want
itself, that is the best

rather

shockingly repressive passage

"A man

abolition

already
possessed
on whom
his parents
not want
if
do
society

if he
he
his

to the smallest
of
portion
right
to be where
he is. At
business

cover
feast
is no vacant
there
for him.
mighty
to be gone,
execute
tells him
and will
her
quickly
orders."2

Nature's
She

Fig 1 John Linnell's portrait of Malthus in 1833, aged 67.

(Reproduced with permission of the governors of Haileybury and
Imperial Service College)

BMJ VOLUME 315

20-27 DECEMBER

1997

1687

Malthus
that the
classes
should
proposed
working
the habits
of the middle
late
classes, who married
copy
the
and had
small families.
He had a poor
of
opinion
classes:
upper
live principally

"Those

among
in towns, often

the higher
the

want

classes,
inclination

who
to

and debate

Education

and debate

movement

AN

meant

had

they

lost

and

their

of
security
common
rights

the

cottages,
some
them
given
Many
independence.3
to live in the
became
destitute
forced
and were

employment,
which
had

ESSAY

that

their

families
workhouses.

ONTHE

Between
1731 and 1811 the population almost
doubled and the price of food increased two and a half

PRINCIPLE OF POPULATION,

times.4

AS IT AFFECTS

peak

in 1811 (fig 4). On

THE FUTURE IMPROVEMENTOF SOCIETY.

6 May

M. CONDORCET,

attributed

Malthus

culture,

dependency
early

LONDON:

and

unrest,

marriage
even

revolution,

were

serious

food

faster

increasing

I798.
is misspelt

in an

illicit

To

his
promote
education:
primary
It is surely
deficient

intercourse

they can indulge

disgrace,

tion of the lower classes of people

be

to a few

left merely

from

subscription
course
of

who

in them

any

in England

ally

should

supported
can
give
of bias
kind

to

a
by
the

had

humane

the

of

to

side
evils

social

was

and

revolution

treatment

than

which
der

character.

his

may

this was

stabilised;
and

agriculture
from
the

and

1811

to

the

enclosures.
for

to rise

continued

Wages
the

labour

children

illegitimate

the

about

and

to be unfavourable

be
supposed
of children."

ill

the

the high

the

understand

economic,
occurring
agricultural

to

rest

the

of

rise,

revolu
century

were
also
In pre
changes.
demographic
the
classes
virtu
England
practised
working
was
to
birth
control?coitus
interruptus
thought

no

a
to afford
to marry
and have
ability of
couple
This meant
late marriage
and
small
families.
or abortion,
Malthus
did not discuss
infanticide

& 900
?Real wage5
?
?Gross
*
reproduction rate
?>
| 800

by the
children.
Though
Darwin

600

\J\

life...

of
the

to the

3.6

500
\\*J/

air,
ten

Malthus's
it

failed,

ideas

and
at

demographic
the time. The

labourers

was

and
to

the
review

reasons
the

which
changes
economic
situation
deplorable.

The

his
social,
were
of

the

3.2

Is ^\

2'8*
24

I
jr\

2-?

400 *^J 1.6

1551

is necessary

j?

700
/\/\

towns,

in England

Changes
policies

improve
of scale

began
industrial

by

for

to

due

economies

300

To

and

He

from

resulting
concerned

in great
in moderate
towns, and even
to the very
unfavourable
early stages
the closeness
and
from
foulness
of

lungs

then

Between

population.

again doubled, but this time food

regarded

in the towns.
"In London,
of children
accord
mortality
one half of the born
to former
died
calculations,
ing
under
three years of age."
to poor
atmos
He
attributed
this
and
housing
seems
to be
"There
pheric
pollution:
certainly

peculiarly
it arises

There

shortages.

abortion,

condemned

something

to food

in 1816.

and
of female
infanticide,
infants,
particularly
as
checks.5
important
positive
to
the
the
pattern,
preindustrial
According
coincidence
and
of stable
food
wages
prices
rising
to rise. Instead,
should
caused
from
have
1840
fertility

which

The other side of Malthus

industrial

to this

encouraged
social
feared

be injurious to health. Fertility was determined

they please."

Malthus

in

industrial

miserably
the educa

Schools,

Sunday

individuals,

instruction

that

thought,
He
families.

There

universal

been

to

(fig 4).

sex."

advocated

have

"[We]
a national

the

with

Malthus

views,

he

large
due

riots

resulting
to the demand
due
tion,

themselves

fell,

prices
ments

the facility with which

to the

tied

industrious

the rising population

which,

1871 the population

marry, from

at

to alleviate

For 250 years before Malthus, population had

been linked to the price of food, with the prices

PRINTED FOR J. JOHNSON, IN ST. PAUL'S

CHURCH-YARD.

name

falling,

1795 the magistrates

low.

wages

keep
AND OTHER WRITERS.

reaching
a nadir
with

men."
This
reduced
the
[employed]
agricultural
an intolerable
to
workers
paupers,
dependent
placed
on the
burden
and encouraged
landowners
parish,

SPECULATIONS OF MR. GOODWIN,

Fig 3 Title page of the first edition. Godwin's

rising,

in Berkshire,
in an effort
Speenhamland
introduced
distress,
"wages,"
supplementary
for
"all
of
and
bread,
poor
price

WITH REMARKS
ON THE

was
fertility
were
real wages

Concurrently,
in 1790, and

1601

1651

1701

1751

1801

1-2
1851

1901

Fig 4 Gross reproduction rates in five year cohorts compared with

25 year moving average of real wage index. Gross reproduction
rates, which were used by Wrigley and Schofield as an index of
fertility,4 are age specific birth rates of women. (Reproduced from
The Population History of England 1541-1871 with the permission of
the authors and publishers)

enclosure

1688

BMJ VOLUME

315

20-27 DECEMBER

1997

Education

onwards, fertility began to fall and continued to fall

until the end of the century (fig 4). This was because
(the

contraception
from
duced

France,

and

able,

condoms

venereal
able

from

disease

were

and

was

had

prostitutes)

been

had

sponge
vaginal
coitus
interruptus
had
been
used

now

mainly
become

to limit

intro

of human

dignity

were

of

several

and

Sailors

food

of material

lation

the

and

food
to

ideas were

regarded

and

supplies

and

energy

to cope

non-renewable
with

the popu

explosion.6

1 An essay on theprinciple ofpopulation. 1st ed. London: J Johnson, 1798.

2 Malthus TR. An essayon theprinciple ofpopulation. 2nd ed. London: J John
son, 1803:531.
3 Hammond JL, Hammond B. The village labourer 1760 -1832. Abingdon:
Fraser Stewart, 1995:100.
4 Wrigley EA, Schofield RS. The population history of England 1541-1871.
London: Arnold, 1981:403.
5 Darwin C. The descent ofman and selection in relation to sex.London: Mur
ray, 1871:134.
6 Meadows DH, Meadows DL, Randers J, Behrens WH. The limits togrowth.
New York: Universe Books, 1972.

the arrival

and

star-bursts,

were

checks

preventive

Malthus's

century

to

refused

population

and

positive

had

however,

the

never

social
policies
socioeconomic

of

limitations
sources

ideas
socially
progressive
in his lifetime. His
implemented
a combination
were
of
defeated
by
an
of
and
the
progress
acceptance
by

advocated

these

between

he

as obsolete but the Club of Rome's The Limits toGrowth

revived the Malthusian analysis by pointing out the

Conclusion

but

the

population.
For almost

nature."

Malthus

tension

the

of
and

supply

respect
families

choosing
couples
material
increased
comfort
and to enjoy
was
to
Malthus
opposed
contraception
violentiy
"A
to it
and
referred
obliquely:
promiscuous
only
as to
to such a
the birth
intercourse
prevent
degree
seems
to lower in the most
marked
children
degree

recognise.
concepts

accept
to avoid

their

which
measure,
preventive
His
contributions,
lasting

effective

and debate

of HTV

Edward Hooper

of a newly
early
history
an academic
is more
than
just
recognised
can
a disease
how
exercise.
To appreciate
help
began
to combat
is
it The
classic
medical
science
example
in
of the cholera
Snow's
epidemic
John
investigation
origins
disease

Golden

Square, London,

handle

of

the

Broad

Street

pump
causation

of

also
may
in the future.

prevent
recent
evidence,

baboon
impact
animals.4

to the

in humans

livers
of

zoonoses?human

us

to control

diseases

In

the

have

case

of AIDS,

three

related

but

in the past
recognised
human
immunodeficiency

three

is the

result

a zoonotic

of

species of African monkey).

of

transfer

from

virus

immunodeficiency

the

sooty

seem
to result from
"main") and O ("oudier")
rate zoonotic
transfers
of different
variants

two

by

contrast,

12.9 million

cumulative

group

has

0.1%, perhaps because

transmissible.
have

lessons

None

the

to teach

us.

BMJ VOLUME 315

infected

in

time

(a

(for

sepa
simian

is divided about whether

Opinion
arose

HIV-1 group M has probably caused over 99% of

the world's

was

in Cameroon

1959

a simian

of

Norwegian

in the world

from

the natural

transfer

this star-burst
simian

virus to humans or from

| immunodeficiency

introduction?for

iatrogenic

of

example,

through

I vaccine

in chimpanzees.

virus

immunodeficiency

that

mangabey

groups M

HIV-1

who

sailor

and

HIV-1 groups M and O). It is now widely accepted

HIV-2

BMJ 1997;315:1689-91

Phylogenetic evidence shows thatHIV-1 groups

IM and O show a "star-burst" phylogeny, with
different subtypes suddenly emerging around
j

the

years?namely
viruses
(HIV-2

similar

The earliest evidence of HIV-1 group M isfrom

1959 and of HIV-2 from 1965. It seems, therefore,
that all three HIVs may have emerged around the

causes

distinct

16

been

arising

to prevent

also

in the future

with HIV-1 group O?probably

1961-2

...

of AIDS

outbreaks

it and

in a young

was

same

Three

Edward Hooper,
writer and medical
researcher

Learning about the origins of a disease may help

The earliest confirmed case of AIDS

catastrophic
from
acquired

potentially
diseases

BN14 7LQ

Summary points

the

contained

help
The
occurring
of new
for
about
the origins
example,
3
sen
variant Creutzfeldt-Jakob
disease2
will, hopefully,
are
who
scientists
sitise
research
those
transplanting
appreciation
events
similar

to

Worthing

in 1854: his removal of the

An

outbreak.1

PO Box 4087,

and

the

Tracking

AIDS

probably

cases

caused

to date5;
less

the virus (like HIV-2)

less,

the

20-27 DECEMBER

rarer HIV-1

may

than

is less
also

Two

mariners

Earlier
reaction
29

year

showed

1997

1689

this year,

...
characterisation
of an archival

sequencing
old Norwegian

that he had been

former

by polymerase
HIV-1
isolate
merchant

chain
from

seaman

infected with a group O