Breadth 1 Flashcards
What was different in pre-industrial Britain?
There were few pressing public health problems.
There was low population density & limited urbanisation.
Vast majority lived, thinly spread, in rural areas.
British population stats
1781
1871
1939
1781: 13 million
1871: 31 million
1939: 48 million
What did the creation of work in factories, mills & foundries due to industrialisation lead to?
It led to a sudden influx of people coming to towns and cities for employment.
This forced many to crowd together in substandard conditions with little by way of clean water or adequate sanitation.
What did the…
- Medical industry
- Chemical industry
- Agricultural industry
- Textile industry
…contribute that led to the death rate falling?
Medical industry produced the smallpox vaccine, preventing many deaths.
Chemical industry started to produce cheap, available soap.
Agricultural industry produced better quality and quantity of food.
Textile industry produced cotton cloth which was cheap and easy to wash.
Why did the birth rate rise?
Because death at a young age became less common, meaning people had children/more children.
This followed through generations.
What was the percentage of people living in towns in 1801, 1851 and 1891?
1801: 33%
1851: 50%
1891: 72%
By 1900, how many British citizens were urban dwellers?
4 out of 5
The influx of thousands and thousands of people led to the influx of what?
What Victorians called ‘filth diseases’.
Typhoid, diphtheria, tuberculosis, scarlet fever, cholera.
How did urban communities respond to overcrowding?
By using up & adapting ‘vacant’ living space, and building new dwellings.
Cellars & attics filled with people, also used as workplaces.
What did lacked in housing that caused problems?
Lack of services to a house, rather than the house itself.
Lacked sewerage, drainage & a regular water supply.
Lavatories were usually in courtyards and alleys.
What was the waste emptied into?
Who cleaned it out & what did they do with it?
Waste emptied into cesspits, cleaned out (from time to time) by night-soil men.
It was collected into dunghills, then sold on to local farmers.
Why was a water supply difficult to get?
Not only was it in short supply, it was expensive, controlled by vested interests (private water companies).
What was the nature of living in the first half of the 19th c.?
Overcrowding
Lack of sanitation
Disease was rampant
Life expectancy was low
What spread typhus fever?
When were typhus epidemics?
Body lice, which many people who were living in unsanitary, overcrowded housed.
1837
1839
1847 - killed 10k people in north-west England alone.
Cholera hit Britain in four massive epidemics.
When were they?
1831-32: killed 31,000
1848-48: killed 62,000
1853-54
1866
What were the two main theories about what caused disease in the 19th c.?
Miasma & germ theory.
What technological development in 1830 allowed L. Pasteur & R. Koch to develop their germ theory?
1830: Microscopes - principally by J. Lister
Could magnify up to 1,000x, thus enabling observation of micro-organisms.
Who identified the germs that caused most of the killer diseases of the 19th c.?
Robert Koch & his team.
Why did cholera epidemics have such a profound effect on legislators & the public compared to other endemic diseases?
The high percentage of fatalities among those contracting the disease, (40-60%).
The speed at which cholera could strike.
There were 30 recorded ‘cholera-phobia’ riots.
Why were people rioting?
It was not directed at the authorities for failing to contain the epidemic, but rather because people feared that bodies were being stolen for dissection for study of the anatomy.
How did the government react to the cholera outbreak?
1831: sent 2 medical commissioners to Russia to assess the outbreak.
A temporary Board of Health set up after their report, who advised gov areas to set up local boards of health.
What did the (temporary) local boards of health do?
Appointed district inspectors to report on food, clothing & bedding of the poor, ventilation, number of people per room.
Issued advice & introduced:
- Houses were to be whitewashed & limed, all infected furniture & clothing was to be fumigated
- Cholera victims to be put in quarantine.
- Food & flannel clothing distributed.
- Temporary fever hospitals to be set up.
What temporary law was passed in 1832, and for what reason?
The Cholera Acts 1932
To allow local authorities to enforce some measures & to finance them from poor rates.
What were the 2 main theories of the cause of cholera?
What else did people do to prevent or cure themselves from cholera?
Contagionist - spread through contact.
Miasmic - bad air, ‘miasma of filth’.
Religious - a punishment from God for sin.
1831, The Lancet - ointment made from wine, vinegar, camphor, mustard, proper, garlic & beetles.
There were many patent medicines which claimed to cure cholera.
What was James Kay’s position & what report did he publish?
Secretary of the Manchester Board of Health
The Moral and Physical Condition of the Working Classes Employed in the Cotton Manufacture in Manchester, 1932
Why was Kay & his report significant?
His report was one of the first detailed reports on the condition on a group of working people.
Kay was one of the first to demonstrate the connection between disease & dirt, & diet.
Kay included the moral condition of the poor in his report.
What was the implication?
That dirty living led to dirty habits.
Who wrote the Report on the Sanitary Condition of of the Labouring Population of GB, 1842?
What was the report based on?
E. Chadwick
The report was based on questionnaires sent to all local boards of guardians.
At first, why did the PLC refuse its publication?
Because Chadwick criticised the water companies, medical profession & local administration.
In 1842, Chadwick published it under his own name, at his own expense.
What were the 4 main points of Chadwick’s report?
He attacked the inadequacy of existing water supplies, drainage & sewerage systems.
He linked PH & the PL.
He pointed the finger at vested interests that stood in the way of improvement.
He stressed the connection between these vested interests, overcrowding, epidemics & death.
What was the reaction to Chadwick’s report, including from Sir James Graham (Home Secretary)?
There was a variety of reactions.
Graham was reluctant to act on the findings & conclusions of what was a private and largely personal report.
He set up a Royal Commission on the Health of Towns to investigate the legislative & financial side of Chadwick’s recommendations.
What report generated in 1844 as a result of Chadwick’s report?
How did the report find its findings?
Report of the Royal Commission into the Sanitary Condition of Large Towns and Populous Districts
Questionnaires were sent to the 50 towns with the highest annual death rates, and the commissioners visited the worst areas.
What did the Report of the Royal Commission into the Sanitary Condition of Large Towns and Populous Districts find?
It upheld Chadwick’s findings.
42/50 towns had bad drainage.
30/50 had poor water supplies.
The second report in 1845 of the Report of the Royal Commission into the Sanitary Condition of Large Towns and Populous Districts contained proposals for future legislation.
What did it recommend?
Central government be given extensive powers to inspect & supervise local sanitary work.
Local sanitary districts be set up, with authority over drainage, sewerage, paving & water supplies.
Also be given powers to raise money for sanitary schemes through local rates.
In the 1840s, how many wool combers were living & working in their own dwellings?
What was the average age of death of a woolcomber?
10,000 woolcombers were living & working in their own dwellings in the 1840s.
The average age of death of a woolcomber was 14.
What did the Bradford woolcombers form in 1845 & for what purpose?
A Protective Society & their own Sanatory Committee to report on their living conditions.
What report did the Bradford Sanatory Committee publish in 1845?
Did the government act?
Report of the Bradford Woolcombers Sanatory Committee
Yes, in 1848.
What was an important breakthrough that came in 1775?
A. Cummings ‘S-trap’.
This sealed the toilet bowl, preventing foul air from coming up from the sewer.
J. Bramah combined this invention with a float valve system for a cistern to build the first flush toilet.
What did George Jennings & Thomas W. Twyford do?
George Jennings revolutionised sanitation by inventing an improved water closet, patenting it in 1852, and making it widely adopted in middle-class homes by the late 1850s.
Thomas William Twyford revolutionized toilets by inventing the ‘wash out’ trap water closet in 1875 and improving it with further patents in the 1880s and 1888.
What breakthrough came in in 1912?
Scientists at the Manchester University developed the sewerage treatment of activated sludge, whereby sewage was biologically treated to make it safe.
Like the provision of sewage, whose hands was the provisions of water in for most of the 19th century?
Private companies.
Whether or not individual companies took advantage of new technology was up to the shareholders who needed to make profit.
Examples of companies investing in modernising water supply
1802 - Lambeth Waterworks
- Expanded & replaced wooden pipes with cast irons ones.
In 1808, West Middlesex Waterworks Company also did.
1829 - Chelsea Waterworks Company
- First to install a sand filtration system to purify water from Thames.
What was a major problem concerning water quality?
Water companies extracted drinking water from rivers polluted by industrial & faecal waste.
Between 1780-1939, what factors pressurised local & national authorities to intervene?
A growing awareness of the nature of the problems created by poor living conditions.
An understanding of the implications of various medical & scientific discoveries.
The authorities intervention resulted in what?
A deeper awareness of the need for reform among the public, press & parliament.
It generated a desire for further change.
How did authors like C. Dickens & E. Gaskell affect attitudes to PH?
His ability to bring characters to life made PH issues, particularly in the workhouse, impossible to ignore.
Serialisation of Dickens’ books.
- Reached a wide audience, including those who could push actual change.
Gaskell’s work, like Dickens’, helped to raise awareness and foster a sense of empathy among the middle and upper classes, which was essential for driving reform.
Did Dicken’s work impact actual reforms or lead to specific reforms?
Yes, it helped to build a groundswell of public support for better living conditions & healthcare.
E.g. ‘Bleak House’, which described workhouses & the poor sanitation, contributed to the PH Act 1848.
How did newspapers (national & local) play a role in raising PH concerns?
Local newspapers (e.g. Leeds Mercury) would report on disease outbreaks, often linking them to poor living conditions.
National newspapers (especially The Times) could influence policymakers.
E.g. their campaign for effective sewerage in London during the Great Stink of 1858.
How did artists contribute to raising awareness of the living conditions of the rural & urban poor?
The visual impact complemented the written word & helped to humanise their struggles.
Artists like Sir Luke Fildes (e.g. his painting ‘The Widower’) were admired by authors such as Dickens.
What did doctors, parishes & county councils improve in the mid-19th c.?
Their record keeping facilities which enabled the production of statistical evidence.
Evidence from the report by the Medical Officer for Health, London, 1892
% of total pop. overcrowded
1. 15%
2. 15-20%
3. 20-25%
4. 25-30%
5. 30-35%
6. Over 35%
Death rates per 1,000
1. 17.5
2. 19.5
3. 20.3
4. 22
5. 24
6. 25
When was the Health of Towns Association established & what was the aim?
1844.
To carry out a propaganda campaign for PH legislation.
What did governments set up in the mid-19th c. to investigate the living conditions of the poor?
Royal Commissions.
E.g. Royal Commission for Enquiry into the State of Large Towns and Populous Districts set up in 1843, reported in 1844.
