IN endeavouring to elucidate the ultimate causes of the
reduction of the death rate we may perhaps roughly classify
them under the heads 'increasing wealth' and ' increasing
knowledge', though these two are obviously mutually inter-
dependent. The main cause of the increasing wealth was
undoubtedly the growth of commerce and, as far as this country
was concerned, the growth of the commerce of London. It
is significant that it was in London, where the wealth and
commerce of the country were largely concentrated, that town
improvement and the great hospital movement had their origin.
The commerce of London re-acted upon agriculture, providing
it both with a market and with capital, and thus it was an
important factor in a remarkable increase in both the quality
and the quantity of the food supply. The wealth of London
encouraged improvement in industry and in medicine. But
wealth and commerce alone could have achieved nothing if
they had not been able to draw upon an ever growing stream of
knowledge in every sphere, in science, in agriculture, in navi-
gation, in industrial technique, in medicine. The growth
of commerce itself had its origin in the great geographical
discoveries of the 15th century, which also placed this country in
a favourable position in regard to foreign trade.

Up to the middle of the 16th century England was a poor
and backward country, her finance and foreign commerce in
the hands of foreigners, her natural resources largely undeveloped.
The discovery of the New World and of the ocean routes to
the East inevitably shifted the world's economic centre of
gravity; the prosperity of the Mediterranean countries tended
to decline and that of the Atlantic countries to rise. England
shook off the foreign yoke and began to attempt long distance
foreign trade and to be less dependent upon foreign finance.

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