The title of the novel is a quotation from the poem Lycidas by Paradise Lost author John Milton: 
 The hungry sheep look up, and are not fed, 
 But swollen with wind and the rank mist they draw, 
 Rot inwardly, and foul contagion spread ... 
 This is an important book, with a capital "I". It is a shame everyone doesn't read it, and even more of a shame that many who would read it would dismiss it as silly liberal propaganda as they have dismissed all discussions on climate change. Because it was written in 1972, before some of the gains of the sexual revolution and civil rights had been realized and when the population of the United States was about 100 million less, some of the words and attitudes seem a bit out of date, i.e. use of fuzz or pig for police; the remarks Peg, as a female reporter, has to endure just because she is good-looking; what is considered wealthy, the price of things and the scale of the economy, etc. Kind of like Dr. Evil in the Austin Powers movies who, because he is transported to the future from the 60s, puts a pinky to his mouth and demands a ransom of One Million Dollars! to save the world from destruction (and everyone giggles). 
 The events that take place, though, don't seem out of place at all with current times. They seem eerily prescient. Any one of the increasingly common news items and disasters in the story could happen, and do, happen every day now in 2012.....pollution, boil water notices, accidental poisonings, acid rain, ruined rivers, streams and oceans, birth defects linked to medications, antibiotic-resistant diseases, endless wars, riots, crop disasters, increasing rate of earthquakes, deforestation, extinction of species, rise of corporate controlled government and total collapse of the environment. The whole world is rotting and the core of that rot is the United States with its population of proud, polluting, entitled, careless, clueless millions with their attitudes of we are the best, our way is the only right way, everything was put on this earth just for us, etc. Or so says the author. 
 The book is written in chapters of varying length, some just a few words, a poem, a sign or a press release. A little disconcerting at first but it all adds up to a concise picture and the inevitable conclusion from Austin Train and others that the only way to cure the Earth's ills is (view spoiler)[ to get rid of its worst offenders....a housewife in Ireland smells smoke, and says to a visiting doctor: "We ought to call the fire brigade, is it a hayrick?" to which the doctor replies, "The brigade would have a long way to go. It's from America. The wind is blowing [from] that way." (hide spoiler)]. Great book.