3.1-The Impetus For Public Health Reforms, 1780-1939 Flashcards
What is public health?
Public Health is the act of looking after the wellbeing and health of
the population as whole (not necessarily just those living in poverty).
Who is responsible for ‘public health’ in 2020? How
do you think this differed to previous years?
In 2020, national and local governments are responsible for public
health. In the past, this may have been local governments but the
responsibility also fell with philanthropists, charities/ volunteers and
the individuals themselves.
Industrial and population changes from 1780-When was the overall population increase the most rapid in Britain?
The population increase in Britain was most
rapid during the height of the Industrial
Revolution (1781-1871).
Why did the death rate fall?
The death rate fell due to improvements in
vaccines and soaps, a bigger quantity and
better quality of food and a bigger quantity
of textiles.
Why did the birth rate increase?
The birth rate increased due to more people
surviving to adulthood and therefore an
increased marriage rate. There was also no
contraception!
How did the distribution of
towns change?
By 1891, 72% people lived in towns
(compared to 33% at the beginning of the
1800s).
What impact did the
increasing population have
on housing conditions?
The increasing population led to
overcrowding, as houses in cities could not
be built quickly enough and people also
had to live close to their workplace due to
lack of public transport. Living space was
often ‘adapted’, eg. cellar and attic
dwellings. New ‘back to back houses’ were
also built. Middle classes left towns/cities.
What impact did the
increasing population have
on sanitary conditions?
Most housing lacked basic sanitation: no
drains, sewers or regular water supply. Privies
(outdoor toilets) were emptied into cesspits.
Water was expensive and owned by private
companies.
What impact did the population
changes have on people’s lives?
🏠The rapid influx of people into towns and cities created poor housing. 🏠Back to back housing and cellar/attic dwellings were seen most frequently. Houses were typically built in a grid system. 🏠A huge number of families would occupy 1 house. 🏠Poorest lives in cellars/attics.
🏡Most housing lacked sewerage or drainage. Instead, they shared a privy. 🏡Cesspits were emptied by ‘night- soil men’. 🏡Houses also lacked a clean water supply. Instead, water was supplied by a communal pump. 🏡However, some middle classes did have access to flushing toilets and running water in their own homes.
What was a privy? What was a cesspit?
Privy = communal toilet Cesspit = area where toilet waste would be put
What were the 3 well-known industrial diseases?
Typhus
Typhoid
Tuberculosis
What are the symptoms of typhus?
- Headache
- Diarrhoea
- Fever
- Nausea
- Vomiting
- Hypotension
What are the causes of the disease, modern day and the 19th century understanding?
Modern understanding – Fleas/ lice/ bites
Early 19th century understanding – Miasma theory
What are the treatments of typhus, modern and 19th century?
Modern - Hygiene, insect
repellent, antibiotics
Early 19th C – Try to
improve sanitation
Name some history of epidemics of typhus in 19th century Britain
1837
1839
1847 – 10,000 people killed in
North West
What are the symptoms of typhoid?
- Headache and body pain
- Loss of appetite and weight loss
- Dry cough
- Sweating
- Abdominal pain
- Swelling in abdomen
- Diarrhoea or constipation
- Itching or rashes
What are the causes of typhoid, modern and 19th century understanding?
Modern understanding – Contaminated food
and water
Early 19th century understanding – Miasma theory
What are the treatments for typhoid, modern and 19th century?
Modern - Hygiene,
vaccination
Early 19th century – Try to
improve sanitation
Name some history of typhoid epidemics in 19th century Britain
Throughout 1800s
1897-8: Epidemic in
Maidstone, Kent kills
2000 people
What are the symptoms of tuberculosis?
• a persistent cough that lasts more than 3 weeks and usually brings up phlegm, which may be bloody • weight loss • night sweats • high temperature • tiredness and fatigue • loss of appetite • swellings in the neck
What are the causes of tuberculosis, modern and 19th century understanding?
Modern understanding – Bacteria
Early 19th C understanding – Miasma theory
What are the treatments of tuberculosis, modern and 19th century ideas:
Modern – antibiotics &
vaccination
Early 19th century-Try to
improve sanitation,
quarantine/ isolation
(in Sanatoriums)
Name some history of tuberculosis epidemics in 19th century Britain
40% of all deaths in Britain’s
cities due to TB
When was the cholera epidemic and what caused it?
1832
Cholera epidemics had a profound effect upon the public. This was because of the high
percentage of fatalities amongst those contracting the disease (40-60%) and because of the
speed with which cholera could strike.
What were the cholera riots?
There were 30 recorded ‘cholera riots’ in towns and cities throughout Britain. In Liverpool, there
were 8 street riots between May and June 1832. The rioters were protesting against the medical
men; they believed that some doctors were murdering cholera patients so that they could use their
bodies for dissection. In Exeter, rioters objected to the burial of cholera victims in local graveyards.
Victims were being buried hastily, possibly before they were dead, and without proper religious
ceremony. Pressure amongst people and politicians for reform was intense.
What was the governments reaction? What advice did they provide?
Although the central government had done nothing about the endemic fevers and ‘dirty’ diseases
that were common amongst all classes in large towns, cholera was different. The government had
to take action. In 1831, the government sent two medical commissioners to Russia, where there
had been an outbreak of cholera. A Board of Health was quickly set up. The Board of Health
advised local government areas to set up their own Boards of Health. It suggested that these local
boards should include magistrates, a clergyman, some householders and one or more medical
men. These local boards reported on the food, clothing and bedding of the poor, the ventilation of
their dwellings, the number of people per room and the ways in which they kept clean and their
behaviour. It also issued advice.
🤢Houses were to be whitewashed and limed. All infected furniture and clothing was to be
fumigated.
🤢People with cholera were to be put in strict quarantine.
🤢Food and flannel clothing were to be distributed to the poor.
🤢Temporary fever hospitals were to be set up.
What were some of the drawbacks?
However, this advice was not the law. Legality became a problem – What legal right did the
boards have to insist that people co-operate with them? In 1832, temporary ‘Cholera Acts’ were
passed to allow local authorities to enforce some measures. Even so, local action was haphazard.
Local Boards of Health were disbanded.
What were the theories about what caused cholera?
The problem with cholera is that it had no known cure.
💧The contagionist theory suggested that cholera was spread by contact with local victims.
This was disputed becasued not everyone in the same household fell ill.
💧The miasmic theory suggested that cholera was spread by infected air. Treatment involved
the removal of heaps of excrement.
💧Patent medicines grew and multiplied in number. All claimed to cure cholera.
💧Prayer was recommended by all the main Christian churches.
It was not until the 1850s, with the proof that cholera was water-borne, did treatment of cholera
epidemics change.
