As to pre-industrial pollution, Caroline might have added a couple of instances:

• Knife grinder's disease --the workers in Birmingham's knife and razor shops suffered and died of silicosis from a life spent over the grindstone.

• Tanning -- the processing of leather stank to high heaven, and spent tanner's liquor was dumped in the nearest waterway.

• Brick making -- brick kilns give off acid smoke most disagreeable to those downwind.

• Above all towns and cities had no sanitary sewers, much less sewage treatment. Open cesspools were normal, and they leaked into the groundwater and the streams.

Aside from pollution, of course, no one had a clue as to the causes of infectious disease in general, and the prospect of fatal illness at any age was a normal part of life in a way we have utterly forgotten.

Swift's account of a London shower in the early 18th century reminded me that in JA's time Paris was a good deal worse than London. French visitors remark with astonishment that London actually has paved areas along the edges of the street that are raised above the roadway and reserved for pedestrians. This innovation, they suggest, might well be copied at home.