HIST 123 Quiz 3 Flashcards
What was Smallpox in the 18th Century?
- 1/3 of all childhood deaths in 17th and 18th c. Europe from smallpox
- Feared also because of scarring it produced
- Example: Chester, England — 1774
- 1200 cases out of a population of 14,700
- 202 deaths
- Affected people of all ranks:
- eg. King William III of England lost his father, mother, and wife all to smallpox in the later 17th century; Emperor Highashiyama of Japan died 1710, aged 34.
- Smallpox went from milder to more virulent in medieval England → increased in severity in 17th and 18th centuries.
- Fear of smallpox laid in potential of mortality and scarring
- when you got the disease you would get the pustules on face and hands and elsewhere and it would leave severe scars
What was Smallpox Like in Chester, England
- 1774
- 1200 cases out of a population of 14,700
- 202 deaths
- Affected people of all ranks:
- eg. King William III of England lost his father, mother, and wife all to smallpox in the later 17th century; Emperor Highashiyama of Japan died 1710, aged 34.
- Smallpox went from milder to more virulent in medieval England → increased in severity in 17th and 18th centuries.
- Fear of smallpox laid in potential of mortality and scarring
- when you got the disease you would get the pustules on face and hands and elsewhere and it would leave severe scars
What was smallpox?
- orthopox virus (genus)
- first disease for which a vaccine was developed.
- Cowpox, monkeypox separate species
- But overlapping immunities
What was Variolation?
- some of first references to this from China 16th century texts
- Would take matter out of smallpox legions (the pus) and then take it and place it in the nostrils or the skin of the person they were trying to variolate.
- Goal was to provoke a mild attack of the disease so that the person gets sick, recovers and has immunity to it going forward
- and/or would have a much milder cases if they got it later on
- People would also intentionally expose their children to ppl who had smallpox in hopes that they would have a mild case and going forward be immune
- In Europe it was largely a folk practice → changed in 18th c. because the disease became more serious
- Hans Sloan (1660-1753) and Charles Maitland (1668-1748) were physicians who advocated for and practiced smallpox variolation
- Caroline, Princess of Wales (1683-1737), asked for experiments on variolation, after which she chose variolation for her own children.
- Tested variolation on 6 prisoners → got sick and recovered and 6th showed no symptoms (probably lied and had it when he was younger) → either way showed variolation was a success
- Also tested on orphans
Who were the pro-variolation people in Europe in the 17th-18th centuries?
- Pro-variolation included ministers, clergymen
- Cotton Mather (well-known minister: learned of the practice from Onesimus an enslaved black man) and Onesimus
- Cotton Mather (in Boston) was a religious leader and surprisingly supported variolation
- In Europe and the colonies
- Cotton Mather (well-known minister: learned of the practice from Onesimus an enslaved black man) and Onesimus
- Anti-variolation included physicains, community leaders
- Because some people would get smallpox and die from it.
- Benjamin Franklin originally opposed variolation until his son got it and died → then became pro variolation (bc he thought he should have tried and done sth more to proect his son)
- Part of it was that they thought it was Gods will whether you got smallpox and died of it → thought clergymen were being hypocritical
What was Benjamin Franklin’s Role in Variolation in the 18th century?
- Initially opposed to variolation
- Argued that it was hypocritical for clergy to promote variolation (went against God’s Providence/Will)
- Then changed his mind after the loss of a son in 1736 to smallpox.
- James Kirkpatrick practiced variolation in the 1740s.
- Claimed he had a safer method.
- Physicians, surgeons, apothecaries detailed that variolation should be preceded by bleeding, purging, and proper diet to bring the body’s humours into balance.
- In some respects variolation wasn’t like 20th c vaccination campaigns that actually had signiifcnat effects on mortality
When was the Smallpox pandemic and what was it?
c. 1775-82
- “Pox Americana”
- Mexico City to Portage La Loche (today: Canada)
- killed a lot of ppl in what is now Manitoba and Saskatchewan
- Continental pandemic
- Coincided with American Revolution (1775-82)
In the Americas, who was most vulnerable to smallpox in the 1750s and 1760s?
- People fighting for the revolution → poor hygiene, wounded, malnourished (weak immune systems), close quarters
- The British hired German soldiers who were coming from Europe → much more likely to be exposed to smallpox as children
- Those born and raised in the Americas → many children of colonists were more vulnerable to smallpox than the Europeans they were fighting against
- Meant that George Washington’s soldiers were more vulnerable to smallpox than the British
The Politics of Differential Immunity
- Washington required his troops to be variolated.
- SEE IMAGE
- During the American Revolution, George Washington also imposed a “vaccination mandate”
- Said there was more to fear from smallpox than the enemy army
- In general, the variolation served to protect the Americans
What was the relationship between smallpox and Washington/the American Revolution in 1775-82?
- Washington required his troops to be variolated/innoculated against smallpox.
- SEE IMAGE
- During the American Revolution, George Washington also imposed a “vaccination mandate”
- Said there was more to fear from smallpox than the enemy army
- In general, the variolation served to protect the Americans
Who was Edward Jenner (1749-1832)?
- practicing physician
- was also an amateur scientist
- approached natural knowledge in a general way
- realized those who got cowpox did not usually contract smallpox
- Disease went from the cows to the dairymaids → those who milked the cows saw inflamed spots appear on different part of the hands and on the wrists
- Cowpox made person kind of sick and had bumps on wrist, but not sick like with smallpox.
- Published his studies
- Began to practice experiments:
- with ppl who are marginal
- orphan → gave him cowpox and then tried to variolate him with smallpox → when the boy didn’t get any sickness with smallpox after being sick with cowpox, this confirmed his hypothesis.
- At the time this was perceived as potentially benefiting those children
- Did these experiments on his own children as well bc he had successful attempts
- Vacca - latin for Cow
- Could take mild, non-scarring disease (cowpox) and it would give you immunity to smallpox
- Vaccine was lymph material from those already infected with cowpox → inject it into the skin
- Not universally well-received by everyone at the time
- Faced opposition from ppl who didn’t like variolation in the first place; opposition also from variolators (stealing their business with the vaccination)
What was the Hudson’s Bay Vaccination Progam?
1838-39
- Vaccination and variolation
- Jenner said vaccination would confer lifelong immunity
- By 1809 it was recognized that you would need to get multiple vaccinations and that it would not have lifelong immunity
- Every time smallpox broke out, they would try to encourage ppl to get vaccinated
- Widespread dissemination of vaccine
- Via Hudson’s Bay company to Canada
- Outside of military conflict, it was in the HBC’s best interest to not have smallpox spread → in the self interest of trade with the Hudson’s Bay Company they did try to provide indigenous ppl with some sort of healthcare, including providing vaccination.
- Encouraged isolation to avoid spread
- Lymph could be preserved by drying and the ivory points used as needles were easy to transport
- could vaccinate one person and use that person to vaccinate others
- some success in 1830s, but lymph was not always working by the time it crossed the Atlantic/made its way there
- other challenges: opposition and support; sometimes indigenous ppl and their families would hear about vaccinations and come into the trade posts to seek them out; in other stories mercenaries would have to chase them down to vaccinate them
When was the Hudson’s Bay Vaccination Program?
1838-39.
What was the Medicine Chest Clause, Treaty 6?
“That a medicine chest shall be kept at the house of each Indian Agent for the use and benefit of the Indians at the direction of such agent.”
- in response to smallpox in the 19th c.
What are other examples of vaccination programs?
- State vaccination programs:
- Russian 1812, Sweden 1816, Britain 1853, France 1902
- Vaccination did not confer life-long immunity
- Liberal states hesitated to compel vaccination; needed also an enforcement bureaucracy
- Public health
- After 1898, England required that vaccine lymph be produced from calves.
What was the result of vaccination programs started in the 19th century?
- Eventually lead to eradication of smallpox in 20th century.
- Smallpox vaccination campaigns, vaccination mandates, and anti-vaccination sentiment.
- Long-standing, historical, shared themes.
Who was Thomas Sydenham (1624-89)? And what did he study?
- Began practicing in London in 1655 investigating smallpox and other fevers
- 1665 Great Plague
- Also the subject of Daniel Defoe’s 1722 novel. (”A Journal of the Plague Year”
- Emphasized environmental conditions and characters of epidemics
- Founder of clinical medicine and epidemiology
- “English Hippocrates”
- trying to understand diseases as a product of their environments
- Clinical Medicine: Deals with the diagnosis and treatment of dieases in human beings. It is also concerned with the prevention of disease and the promotion of health.
- Epidemiology: The study of the determinants, occurrence and distribution of health and disease in a defined population.
What is Clinical Medicine?
Deals with the diagnosis and treatment of dieases in human beings. It is also concerned with the prevention of disease and the promotion of health.
- Sydenham was the founder.
What is Epidemiology?
The study of the determinants, occurrence and distribution of health and disease in a defined population.
- founded by Edward Sydenham
What were Bills of Mortality?
- Used to inform the royal court and other elites about the number of cases of plague that were circulating in London so if it got really bad they could get out of town.
- Used as a means to chart cases of disease and their spread through time
- They were collected by parish clerks → when a death was reported to them, they reported it.
- eg. King’s Evil → Scrofula
- Systematic record → has accuracy and consistency to it as well
- This is a bad plague week
- They only applied to people who were the members of the Church of England
What is the role of urbanization in spread of disease?
- Role of urban environments in the spread and control of disease
- SEE images
- A lot more travel between urban centres → bring in more disease
- Dramatic rate of urbanization: top: London relative to other cities
- Bottom: dark black at bottom is London
What were the major infectious diseases in the 19th century?
→ all except tuberculosis were thought to be miasmatics (bad air diseases)
- Whooping cough (pertussis)
- Measles
- Scarlet Fever
- Diphtheria
- Smallpox
- declining importance bc of vaccinations
- Typhoid
- called “filth disease” → directly connected to unsanitary conditions found in urban environments
- Typhus
- called “filth disease” → directly connected to unsanitary conditions found in urban environments
- Cholera
- Tuberculosis
→ caused a lot of deaths in 19th c.
→ by 20th c. steep decline in death from disease
What were Miasmas?
- Belief that most, if not all disease, arose from inhaling air that had been corrupted by decaying matter.
- Eg. waste that was breaking down → believed the smell was signalling that you were inhaling sth that is making you sick
- Apparent in the smell and texture of the air.
- SEE Edwin Chadwick quote
- All smell is “immediate acute disease […] all smell is disease”
- Diseases are bad smells
What was Cholera like in the 19th century according to the Annual Deaths from Infectious Disease 1853-1882?
- Cholera → comparatively low death count but then it has peak years
- Marked as being not neccessarily the worst disease in terms of mortality but did have dramatic impacts
- episodic impacts
- prominent in 19th c imaginations of disease → people terrified of it → but overall it was not that bad
What was Cholera like in the 19th century imagination?
- Cholera tramples the victors then vanquished both
- Cholera in the 19th c. European imagination
- Cholera came and arrived in Europe through a series of Pandemics
- People would get word that it was spreading → frightened of the imminent arrival of it before it arrived
- Cholera product of new technology → steamships, printing → brought disease and news of cholera
- When it reached the industrial slums → ideally suited fro the spread of the disease due to bad quality of water and hygiene
- 1837 (Victorian era) → so concerned about modesty so if you have a disease like cholera that causes vomitting and runny diaherra → part of fear of cholera was modesty based
What is/was Cholera?
- Vibrio cholera (bacteria) ingested through contaminated water or seafood, propelled into host’s intestinal lining.
- Secrete a toxin that ruptures the bonds between cells
- Cells empty salts and water into the gut
- Heavy vomiting and watery diarrhea
- Unless fluids and salts are replenished → death from dehydration
- Effective way of spreading bacteria to others → if these secretions get into water that other’s consume → easy spread
- Can see it pop up during war → harder to get clean water for treatment
Live on their own or in association with plankton - Flourish in estuaries → where salt and fresh water mix
- once good conditions arise → flourishing of this bacteria → likely to spread to humans
What is the bacteria that causes Cholera?
- Vibrio cholera (bacteria) ingested through contaminated water or seafood, propelled into host’s intestinal lining.
How does the Vibrio cholera work and what are the symptoms?
- Vibrio cholera (bacteria) ingested through contaminated water or seafood, propelled into host’s intestinal lining.
- Secrete a toxin that ruptures the bonds between cells
- Cells empty salts and water into the gut
- Heavy vomiting and watery diarrhea
- Unless fluids and salts are replenished → death from dehydration
- Effective way of spreading bacteria to others → if these secretions get into water that other’s consume → easy spread
- Can see it pop up during war → harder to get clean water for treatment
When were the Cholera Pandemics?
- 1817-24: Began near Kolkata, spread through much of Asia including China and Japan
- 1829-37: Spread from India to Asia, Europe and the Americas
- 1846-60: Spread globally, most deadly pandemic
- Worst outbreak in London’s history (over 14,000 deaths)
- 1863-75: Spread to Europe, Africa, North America.
- Indian Muslim pilgrims visiting Mecca spread it to the Middle East (30,000 of 90,000 pilgrims died)
- 1881-96: Spread through Asia, Africa, South America and parts of France and Germany. Kept out of Britain and US.
- 1899-1923: Killed more than 800,000 in Indian before moving into the Middle East, northern Africa, Russia and parts of Europe.
When was the most deadly pandemic in terms of Cholera?
1846-60: Spread globally, most deadly pandemic
- Worst outbreak in London’s history (over 14,000 deaths)
How did 19th/20th century people try to deal with Cholera?
- During pandemics would impose quarantines and enforce isolation
- Obstruct bodies, wash ans fumigate
- But not necessarily that effective because the pathogen travelled by water.
- SEE IMAGES
- Quarantines at this time required ppl be washed regularly and their clothings and belongings be fumigated → not super helpful → ppl can be infected with cholera before they started showing signs
When was the period of Urbanization and what was its effects?
- Medieval European cities with > 100,000 people
- Paris, Venice, Naples, Genoa, Milan
- Between 1500-1700 add to these five:
- Antwerp, Amsterdam, Rome, Palermo, Seville, Lisbon, Madrid, Messina, Marseilles, Vienna, London
- Number of smaller cities also multiplied
- Urban densities
- London 1799 denser than Manhattan 1990
- London’s population in 1840 ~2 million
- Led to development of slums:
- live in muck and filth
- No priviz → places where you dispose of filth → lack of management of human waste
- Sewers before 19th c were about controlling surface waters
- 19th night soil men who took the filth from the pits and took it out of the city
- Cesspools → liquid waste
- 1820 → volume of liquid waste started to increase → sometimes cesspools would overflow → starts to omit odours
- If you have more people producing waste, need more water for people to eat → more wells dug → proximity of wells to cesspools → source of contamination
- More of a problem if it was liquid wast ethan solid waste - >more opportunity for contamination
- Between 1815-1830 condition of Thames deteriorated rapidly → putting waste into the Thames
Cholera and the 1870s: What happened?
- 1870s → came up with a way to test water for sewage
- Tested wells
- ones that people liked the taste best were most contaminated
- Before 1840s water companies rarely filtered water before distribution → even systems at this point were not great
- Water was polluted in the early 19th c.
- Can see why cholera could them appear in these explosive epidemics in the 19th c.
Who was William Farr and what was his connection to Cholera?
- published report on cholera in 1848-1849
- Used statistics from British cities
- Believed that cholera was spread through miasmas → poisonous air that hovered over cities
- Believed airs at sea level were more dangerous than those at higher elevations → strongly believed elevation was a big factor → lower areas is usually where more poverty/people lived in poverty
- Contagion-contingent theory
- Well-received at the time → offered coherent understanding
Who was John Snow and what was his connection to Cholera?
surgeon, - apothecary, physician (1813-1858)
- Didn’t buy into Farr’s theory
- Known for contributions to science of anaesthesia
- Cholorform to Queen Victoria during birth as anesthetic
- Interested in cholera because to him, clearly not a gas
- argued it was the bad water quality →
- One of the earliest modern epidemiologists
- used mortality reports that the city was producing, and gathered info from the companies that were supplying the city with water in different neighbourhoods, asked ppl sick with cholera where they were getting their water from
- 1850s second cholera pandemic in Soho where he lived → went from place to place still doing his research
- determined the source of cholera was a pump on Broad street were people took their water from
- cases concentrated around this particular pump
- 1855 published his work with the map and showed the connections between high cholera mortality and different water suppliers in the city of London → one company had 8x the rates of cholera than those getting their water form other companies → connection between water and cholera
- More ppl believed Farr’s contingent-contagion than the water theory/epidemiological theory
What was the continued debate over cholera?
- Snow’s findings emphasizing the role of contaminated water during 1854 epidemic were not universally accepted
- Some argued outbreak already on the wane when pump handle removed
- Snow died in 1858, before bacteria identified and the accuracy of his insights proven.
- Retroactively seen as correct.
What was Tuberculosis also referred to as?
Phthisis
What was Tuberculosis/Phthisis like in the 19th century (1853-1881)?
- Phthisis/tuberculosis is way higher than others
- It is consistently high
- Tuberculosis was the major 19th c. killer
- Was not an epidemic → just like a wall of disease
- Tuberculosis is an ancient disease
- Hypocrates → “consumption” → but consumption meant a wasting disease, so cases of cancer were also causes of consumption as well → but cancer was relatively uncommon and tuberculosis was quite common so can most the time write them as tuberculosis
What was Tuberculosis?
- Phthisis = pulmonary TB
- Can infect any organs
- (glands - scrofula/king’s evil; blood - miliary TB; bones, brain, etc.)
- Mycobacterium tuberculosis
- Mycobacterium bovis
- introduced in the Americas → spread from cattle to bison
- majority of cases of human cases are caused by mycobacterium TB
- if humans get mycobacterium bovis → usually from contaminated milk or meat of a contaminated animal
→ Both cause TB disease in humans.
→ And related to Mycobacterium leprae which causes leprosy.
→ similiarity to cancer in that it is not an organ-specific disease
What was 19th c. Tuberculosis and how did it spread?
- M. tuberculosis (myobacterium TB) responsible for 98% of pulmonary TB cases and 70% of non-pulmonary TB
- 3 routes of transmission
- Infection usually airborne.
- Dust, spit, droplets in the air
- Crowded conditions and poor ventilation are key to spread of TB
- Understood as a disease of poverty, in part due to crowded, poorly ventilated conditions.
How can Tuberculosis present?
- Acute or latent
- Periods of remission
- Causative germ lodges in the body
- Bodies immune system begins to react
- A tubercule gets walled off → immune system causes it to be enclosed
- Immune response
- Walled off “tubercule” contains the bacillus and prevents further spread
- Person will test positive for tuberculin test (developed in 1908)
- didn’t necessarily have active tuberculosis → weren’t necessary actively sick with the disease at that time
- the disease might never become active in their body → may stay latent → still healthy
- In some ppl, disease would become active
- Factors that affected this depended on person’s immune system and genetic factors
- Often find active cases clustered in families
- Would also see ppl who have weakened immune systems developing active TB disease (impoverished ppl)
- But no clinical symptoms of disease.
When did Epidemic waves of Tuberculosis start to spread?
- In England, epidemic waves of TB began in the 16th c. and peaked around 1780
- At the time estimated 20% of all deaths due to ‘consumption’.
- Declined in late 19th century, but even after 1900, remained a leading cause of death in Western Europe.
- 1944-45: development of effective antibiotics.
- so could be treated by antibiotics bc it was a bacteria.
- Persists into the modern world
- Actually huge as a cause of mortality globally
- Concentrate in subservent Africa → due to HIV and synergistic effects with TB → weakens immune system → susceptible to TB
- Some forms of TB have developed antibiotic resistance
What are the Symptoms of Tuberculosis?
- Shortness of breath, phlegm and spit with blood in it, ppl would become very pale
- Was a belief at the time that TB was hereditary → but was really that vulnerability has a genetic pattern to it
- Growing understanding that there might be contagion involved.
What were early understandings of TB like and who contributed to these early understandings?
- Benjamin Marten in 1772 proposed “an animalcule or their seed” transmitted by the “Breath [a consumptive] emits from his Lungs that may be caught by a sound Person.”
- Others saw lesions as a form of irritation, caused by improper food or ingested matter, or muscular or nervous exhaustion.
- Dissections showed lesions on the lungs
- Hereditary, contagion, irritation of tissue.
What was the Romanticism of TB?
- TB tie to culture
- started to associate it with upper society even tho the vast majority of victims of TB were poor (later acknowledge in 19th and 20th c.)
- Whitening powders replaced rouge
- Emaciated look fashionable for men
- Thin, pale women in pre-Raphaelite art
- Consumptions and love connected in poetry and literature
- John Keats → contributed to fashionable imagery of TB
- Aesthetic value: pale skin, red cheeks → from TB infection
- TB became connected to ppl’s character
- Idea that it was sth about the person’s personality that was contributing to the progression of their sickness as well -> bc it has not expressed itself, passion moves inward, striking and blighting the deepest cellular recesses (Susan Sontag)
What was the Late 19th c. Transitions of TB Like?
- In many part of the world including places that had urbanized and industrialized relatively early (eg. Western Europe). TB disease on decline in late 19th c.
- Shift away from previous romanticization
- Rise of new treatments, eg. sanatoria
- Mountain destinations around hot spring s→ clean air, health benefits
- Elsewhere, TB disease on the rise particularly among poorer populations and Indigenous populations in the Americas
- Extirpation of the bison
- Undermined the food security and health of indigenous plains populations
- Indigenous ppl pushed on to reserves
- Western agricultural settlement and treats
- Cows and plows settlements → gov’t agreed to give Indigenous ppls supports to transition to agriculture but didn;t actually give them support
- late recgonition that the gov’t owes them
- Confined to reserves
- Small, often poor land for agriculture
- Not given supports to shift to agriculture
What was Tuberculosis like in the Northwest?
- Arrived in fur trade from both east and western Canada
- Dominant Mycobacterium tb lineage in west shared with French Canadians
- Also widespread among Russian fur traders in Alaska
- Reports of consumption and scrofula
- Became much more widespread and serious in 20th c. why?
- Residential schools
- Peter H. Bryce
- Gov’t health officer responsible for western Indigenous peoples health
- Advocated for government intervention in residential schools where TB was widespread
- Indicated FIle Hills colony residential school → 60% of alumni had died from TB due to poor conditions and lack of sanitation in the schools → gov’t was directly responsible for such conditions
- Gov’t ignored the recommendations
- Published the story of a National Crime when he retired
- Gov’t didn’t want to spend the many and get the resources to make the schools healthy places
- Disproportionate amount of deaths from Indigenous kids in residential schools -> - TB rampant in residential schools - >aggravated by malnutrition and milk from cows that have bovine TB
- Indigenous ppl thought to be more prone to TB and that their schools were healthier than their homes
Who was Peter H. Bryce?
Government health officer responsible for Western Indigenous peoples
- Advocated for government intervention in residential schools where TB was widespread.
What was TB Like in Canada’s Residential Schools?
- Graves found at residential schools and significance of disease as a cause of death.
- Schools reproduced the worst of urban environments
- Combined with failures of care and inadequate medical assistance:
- Racist ideas about Indigenous health.
- Costs of proper health care, adequate diets, and refusal to pay.
→ Ages 0-9 and 10-20 mostly died → family might lose all their children to this disease.
When did there start to be a shift in focusing on Sanitation?
- Shift in attention to improving sanitation in the 19th c.
- Cities better constructed in 14th c than wooden construction in 19th century
- and in 14th c. better water supply
- New problems in 19th c of deterioration
What were some reason sanitation reform came about in the 19th century?
Problem of Overpopulation
- Dramatic growth of population in cities during 19th c.
- Eg. NY exploded in terms of population
- Due to accelerated industrialization
- Dramatic population growth → overcrowding
- building buildings quickly → bad quality
- Cows, horses, chickens also part of the urban environment in early industrialization of cities
- Horses important for mechanical power and work
- Horses produced a lot of waste
- Left pounds of manure on the street everyday
- Disgusting streets had effect on public health
- Other kinds of waste also accumulated in cities
- Piles of waste in the road
- overflowing garbages
- End of 19th c. → end of street manure → flushing waste into cesspools
- Cesspools were not well-designed: often leaked into surrounding soil, even when they were cleaned there could be leakage
- some cleaned only once a year
- Sewers at the time were really large tunnels designed to be really large in part for maintenance.
- Designed originally to pull water out of the city
- Only once waste started getting flushed into the sewers, that it became their purpose.
- Sewers became places for the city to flush their waste
- 19th c human waste and waste from slaughterhouses flushed into rivers\
Who were the major sanitarians in the 1830s and 1840s?
- Rene Villerme (1782-1863)
- France, le parti d’hygiene
- used outbreak of cholera in Paris to show statistical relations to cholera, mortality and poverty → poor living conditions contributing to disease
- Lemuel Shattuck (1793-1859)
- USA (Boston), 1841 publication of vital statisics of Boston
- showed connections between declining health and deteriorating urban environment
- but also moral connection → decline in living conditions leading to decline in moral value
- public health and sanitary reform to control human behaviour
- Edwin Chadwick (1800-1890)
- English social reform
- he wondered if it might not be cheaper in the long run to improve ppl’s health through sanitation instead of just trying to deal with epidemic disasters as they came (preventitive measures)
- Followed philosopher Jermey Bentham
- said disease was due to bad air
- English social reform
What was Edwin Chadwick’s connection with Miasmas?
- Disease due to bad air with harmful particles in it
- If places smell bad and the air is poor, these are places that have poor health
- Health of rural areas compared to sickness of cities
- Obsessed with how to solve the problem of filth and bad ventilation → thought it greater than the loss of death from wounds
- Born in a farmhouse where washed all over everyday
- A key to a clean society was wash everyday and provision of integrated water system for towns
- Prevention of disease becomes a sort of technological problem and technological solution to social problems
- Engineers in part responsible for disease prevention
What was the role of Water-and-sewer systems in the prevention of disease in the 19th c?
- Prevention of disease as the responsibility of engineers
- Fresh supply of piped water to every house
- Use hydraulic force to push wastes and sewage along
- smaller pipes too → so it didn’t just sit in pools
- Needed government intervention
- Property rights
- Overlapping authorities
- Chadwick recommended single local authority under central government expert guidelines
- 1848 Public Health Act and Central Board of Health
- compelled ppl to service their sewers and cesspools
- raise taxes to pay for this
- Emphasis in sewer systems reflected concept of miasmatic diseases
- Emphasized era more than water but with snows work, there was an integration that polluted air was part of this too
