Medicine & the industrial revolution

Question 1

How did industrialisation affect population and urban growth between 1750 and 1901?

Answer 1

• The Industrial Revolution led to people moving from rural areas to cities for work
• Factories powered by steam replaced home-based production
• Cities grew rapidly as people moved to urban areas for jobs
• Example population growth (1801–1901):
  
  • London: 1.1 million → 5.5 million
  • Greater Manchester: 334,000 → 2.1 million
  • Glasgow: 46,000 → 571,000
• Public health systems could not cope with the massive increase in population

Question 2

What were housing and sanitation like in industrial cities?

Answer 2

• Factory owners built cheap, overcrowded housing for workers
• Back-to-back terraced houses were common, with families in one room
• Lack of clean water, proper sewage systems, and toilets
• Toilets were shared by many families, usually located outside
• Water came from street pumps, often contaminated by nearby cesspits
• Cracked pipes meant human waste mixed with drinking water → caused disease outbreaks

Question 3

How did air pollution affect health in industrial towns and cities?

Answer 3

• Coal was burned in huge amounts to power factories and mills
• Created thick smog that hung over cities
• Smog caused breathing problems and damaged lungs
• Air pollution led to early deaths and increased respiratory diseases

Question 4

What diseases were common in overcrowded industrial towns, and how did they spread?

Answer 4

• Overcrowding and poor public health systems helped disease spread
  Cholera:
  
  • First arrived in 1831, killed around 50,000 people
  • Spread through contaminated water or food
  • Caused diarrhoea, vomiting, dehydration, and often
    death
  • Epidemics in 1831, 1848, 1854, and 1866

Typhoid:
- Also spread by contaminated food/water
- Caused high fever, fatigue, and was often fatal

Question 5

Who was Edwin Chadwick and what did he do to improve public health?

Answer 5

• Edwin Chadwick was a lawyer and social reformer
• Wanted to improve the living conditions of the poor
• Wrote the Report on the Sanitary Conditions of the Labouring Population of Great Britain in 1842
• Found that life expectancy was much lower in industrial towns (e.g. Manchester: 15–19 years) than in rural areas (e.g. Rutland: 52 years)
• Argued that the government should provide clean water and sanitation for all

Question 6

What did Chadwick’s report reveal about life expectancy in Britain?

Answer 6

• People in urban areas had much shorter life expectancy than those in rural areas
• Labourers in industrial cities like Liverpool and Manchester: 15–19 years
• Professionals in rural areas like Rutland: up to 52 years
• Showed a clear link between poverty, poor public health, and early death
• Helped push for government involvement in public health

Question 7

What was the government’s attitude toward public health before reforms?

Answer 7

• In the 19th century, most people believed in laissez-faire (non-interference by the government)
• Many thought public health was a personal responsibility, not the government’s job
• Some people feared the government interfering in their lives
• Letters and articles in newspapers (e.g. The Times, 1852) showed resistance to reform
• This reluctance delayed action on improving health and sanitation

Question 8

What was the 1848 Public Health Act and why was it important?

Answer 8

• Passed in response to Chadwick’s report
• Set up a Central Board of Health to oversee public health
• Local authorities could set up a local board of health if mortality was over 23 per 1,000
• Local boards could raise taxes to fund clean water and sewer systems
• Although not compulsory and had limited funding, it was a major first step toward government responsibility for public health

Question 9

Who was John Snow and what did he investigate during the 1854 cholera outbreak?

Answer 9

• John Snow was a London physician during the 1854 cholera outbreak
• He did not believe in miasma theory (the idea that bad air caused disease)
• Believed that cholera was spread through water, not air
• Decided to investigate the source of the outbreak in Soho, London

Question 10

What did John Snow’s investigation involve?

Answer 10

• Mapped cholera deaths in Soho and found a cluster around Broad Street
• Discovered that victims had used the same water pump on Broad Street
• Found that a nearby cesspit had likely leaked sewage into the water supply
• Workers at a local brewery were unaffected — they drank beer, not pump water
• Snow persuaded the council to remove the pump handle
• Cholera cases stopped, confirming the pump as the source

Question 11

What was the significance of John Snow’s discovery?

Answer 11

• Proved that cholera was waterborne, not spread by miasma
• Discredited miasma theory for cholera, even though some still believed in it
• Could not yet explain the role of germs, as germ theory wasn’t accepted until later
• Louis Pasteur’s work on germ theory later supported Snow’s findings

Question 12

How did Snow’s work contribute to public health reforms?

Answer 12

• Snow’s findings highlighted the importance of clean water supplies
• Helped influence local councils and the government to take action
• Led to improvements in sewage systems and water sanitation
• Played a part in later public health reforms, including national efforts for cleaner living conditions

Question 13

What was the Great Stink and how did it affect public health policy?

Answer 13

• Happened in the summer of 1858 during hot and dry weather
• River Thames water levels dropped, exposing raw sewage and waste
• The smell was overwhelming, forcing the Houses of Parliament to close
• People used chloride of lime to mask the stench, believing in miasma theory
• The crisis pushed the government to take action on public sanitation

Question 14

What did Joseph Bazalgette do to improve public health in London?

Answer 14

• Hired to design a new sewerage system after the Great Stink
• Began designing in 1858, completed in 1875
• Built hundreds of miles of sewers to divert waste away from the Thames
• His system helped end cholera outbreaks in London
• Major achievement in improving urban sanitation and public health

Question 15

What was the 1875 Public Health Act and why was it important?

Answer 15

• Passed by Prime Minister Benjamin Disraeli’s government
• Marked a shift away from laissez-faire to active government involvement
• Required local councils to:
  
  • Provide clean water
  • Build sewerage systems
  • Appoint medical officers
• Made public health measures compulsory, unlike the 1848 Act
• Helped reduce disease and improve living standards

Question 16

What other reforms were passed in 1875–1876 to improve public health?

Answer 16

• Artisans’ and Labourers’ Dwellings Improvement Act (1875):
  
  • Set new standards for housing quality
• Sale of Food and Drugs Act (1875):
  
  • Tightened laws around food safety and labelling
• Rivers Pollution Prevention Act (1876):
  
  • Aimed to clean up rivers and protect the water supply
• These acts showed growing government commitment to tackling health problems

Question 17

Who was Charles Booth and what did he discover about poverty?

Answer 17

• A social reformer who studied poverty in London in 1889
• Created a colour-coded map showing rich and poor areas
• Found that 35% of Londoners lived in extreme poverty, even with full-time jobs
• His work revealed that public health reforms hadn’t fully solved poverty-related health issues
• Encouraged further reform by proving the scale of poverty in industrial Britain