Urban areas doubled, tripled, or quadrupled in size which led to over crowding in cities. Sometimes a large population is a good thing, but in this case the population was too big and caused many health problems.
If it’s the right hand spaces are FACE (f, a, c, e) from bottom to the top. The line notes are every good boy deserves fudge (e, g, b, d, f,) from bottom to top