Public health Flashcards
The story of how government scared the sick people and tried to prevent disease
Name four systems of public health used by the Romans.
- Aqueducts: built to transport fresh water
- Public bath houses: built with minimal enterance fees
- Communal public toilets
- Drainage system: carried away sewage and waste water
Who was in charge of Medieval Public Health and why was this problematic?
Local Leaders usually Knights or barons of each area were in charge of the public health of that area it but with towns starting to crop up after Norman invasion town started to fall in their own councils and tried to make laws to keep the streets clean but without police force these laws were difficult to enforce
What does public health encompass?
Hospital
sanitation
quality of food and availability of clean water
working conditions
1298 what law did King Edward first make?
He ordered that public latrines might be built in York so the city was more hygienic for his soldiers preparing for invasion
In 1330 What law did the Glamorgan council pass?
passlaw to stop butchers throwing animal remains nto high streets/ close to town gates
What did the London council do in 1374?
Gave up trying to control sewage disposal over the walbrook stream and instead make locals pay a fee to have it cleaned once a year
What did parliament do in 1388?
Passed a law finding 20 pounds if anyone is caught throwing “dung, garbage and entrails” into ditches, ponds or rivers
What 3 laws did Coventry make in 1521?
1 people had to clean the streets in front of their houses weekly
2 all the latrines in the red ditch stream must be removed to prevent flooding
3 banned the dumping of waste in the river sherbourne
What difficulties and limitations faced mediaeval public health?
1 People had no idea of the causes of disease and still believed in the miasma theory
2 Lots of people thought illness was God’s punishment and that there was nothing to be done to prevent it
3 There was an extreme volume of rubbish which was often dumped into rivers and the government didn’t see the public health as their responsibility so was left to build up
Give five ways public health in mediaeval Britain was bad
- The feudal system meant that the majority were too poor to pay for physicians and were left to the hands of Barber surgeons and wise women
- Poor sewage systems meant that sewage was dumped on the streets or into rivers this polluted water was then used to clean clothes and cook
- Houses were made of wattle and daub which was unsanitary and rotted away easily
- Businesses would throw waste onto the streets or in water sources
- Houses overhung the streets leaving them dark and crowded a perfect breeding ground for rats, lice and parasites
Give five ways that mediaeval public health was good in Britain
- Muckrakers were hired to clean the streets
- Gong farmers cleared out cesspits and latrienes
- Crusaders in the Middle Ages brought soap back from Middle East
- Monasteries strict rules about public health including fresh running water and clean towels with four compulsory baths a year
- There was strict rules about the quality of food sold by businesses
- Towns had bath houses
Latvets are washrooms
Flush reredorters are latrines
monesteries had both of these
New feature of life in Renaissance England
How did classical texts in the Renaissance period influence medical innovation?
Rich families paid for people to research classical texts and come up with new ideas. Meaning theories of Four Humours and methods like blood letting may b questioned. Copy their public health methods.
New feature of Renaissance England
Human dissections.
Human dissections became more common. Leonardo Da Vinci dissected more than 30 bodies.
Impact on treatments, surgery and public health?
New feature of Renaissance English life
Printing Press
Made in 1451 in Germany and allowed books to be copied quickly.
How would this impact treatments, surgical knowledge and public health?
New feature of Life in Renaissance England
Education
Education became more valued as literacy rates for men went from 10% to 30% during Liz’s reign
How would this impact disease, surgical knowledge and public health?
New feature of life in Renaissance England
Protestantism
Martin Luther began to question the Catholic Church and created the Protestant fiath. More people were now questioning what the Church said.
How would this impact treatment, surgical knowledge and public health?
New feature of life in Renaissance England
The Golden Age of Discovery
Led to trade from new land and access to new knowledge around the world.
How would this impact treatments, surgical knowledge and public health?
New feature of life in Renaissance England
Art
Became very focused on the human body and new artists wanted to be as accurate as possible in their paintings. This led to a desire to learn more anout the body.
How would this impact treatments, surgical knowledge and public health?
What was the Renaissance?
Describes the period between the 14th and 16th centuries where there were new developments in resarch, science and the arts throughout Europe.
What occured in 1871?
rivalry between Pasteur and Kock increased after France had lost a war against Germany, leading to desire for medical research
How did Pasteur and Kock’s governmental support lead to change?
They were both given honorary awards: kock got 1905 Nobel Prize and Copley Medal of 1874 for Pasteur
Both had a team of scientists and labs
What happened in 1879?
Pasteur investigated chicken cholera when Chamberland (his assistant) accidentily used a weakened microbe but found these chickens survived real infection
What happened in May 1881?
Pasteur demonstrated his anthrax vaccine infront of politicians and journalists and electric telegraph sent and word of his success
What happened between 1880-84?
Pierre Roux, Chamberland and Pasteur developed rabies vaccine on rabbits but reluctant to use it on humans (developed in 1885 by them)
What happened between 1888-90?
Roux, Pasteur’s student, showed that diptheria germ produced a toxin
What happened in 1890?
Emil Behring, Kock’s student, showed that weakened disphtheria germs could be used to produce an antitoxin.
What was the disease common in the early industrial period?
smallpox, killing 60% of Londoners
What was developed in 1853?
Jenner developed a vaccine for smallpox, but it wasn’t until 1853 that the gov. made it compulsory to be vaccinated
What did people in the 19th century believe about germs?
Germ Theory meant people focused on hygiene and no longer believed in spontaneous generation, so would take prenetrative measures against germs.
What does laissez-faire refer to?
laissez-faire attitude of the gov. meant they did not help public health, not ‘interfering’ with people.
What happened in 1848?
Public Health Act said that local councils could improve living conditions
What was the Great Stink?
The human and Industrial waste in the River Thames that caused a ‘great stink’
July-August 1858
What was the 1875 act?
Public Health act included savage systems, rubbish collection and councils were now forced to protect public health.
Who was Edwin Chadwick?
A social reformer who wanted to improve public health and tried to get the gov. to form a Board of Health to look after the poor’s health by promoting the ecenomic benefits of healthy workers
Who was John Snow?
A scientist who disbelieved miasma and uses scientific method to prove polluted water, cause of cholera.
When was Edwin Chadwick born and when did he die?
1800-1890
Who was Edwin Chadwick?
The social reformer led a gov. report into public health following the cholera epidemic of 1842
What did Chadwick conclude?
‘There is an urgent need to improve the living conditions of the poor’
since poor lifestyle= poor health
What did Chadwick suggest?
suggested implementing ‘boards of health’ who could wash the streets and access clean, running water. Trying to convince the gov. with an ecenomic angle.
Healthy workers= more production
How many people died in the cholera epidemic of 1848?
14000 people
What did the 1848 cholera epidemic force gov. to do?
made a ‘board of Health’ with Chadwick as chair and create the Public Health Act
What happened in 1821?
cholera killed around 50,000 people and cemeteries had to close because they were too full and started to poke through the ground’s surfuce, letting of a stench
What did Bilston, West Midlands, Vicar say about cemeteries in 1800 cholera epidemic?
‘The coffins could not be made fast enough for the dead’
What happened in 1839?
set up an inquiry to find out what the living conditions and health of the poor were like all over Britain
What happened in 1842?
Chadwick led this report and published his findings in 1842, over 10,000 free copies were handed out to politicians, journalists and any who could change public opinion
20 thousand more were sold to the public
What did Chadwick’s report highlighted?
A need for cleaner streets and water, even though he believed in the miasma theory
showed parliment had to improve public health for the poor
When was Dr. John Snow born, and when did he die?
1813-1858
What happened in 1849?
Snow published a book claiming that dirty water caused cholera and went against the popular miasma theory
What happened in 1854?
700 people died around Broad St., Soho, due to Cholera
The epidemic Snow investigates
What was Snow’s scientific method to prove the cause of cholera?
- He removed the handle from the water pump and no one else died
- Found that the lady who died in the same outbreak got the polluted water from Soho because she liked the taste
- No one in the brewery across the street died, because they had all been drinking beer and not water
Snow found a toilet only 1m away from the pump, leaking
When was Snow credited for his conclusion about cholera being caused by polluted water?
Laissez-faire and miasma theory, Snow was not credited until 30 years after his investigation, when Kock discovered the microbe that caused cholera
Why didn’t parliment act about public hygiene before 1848 and what do they then do?
Parliment members were making a vast fortune from the rents in slums and getting rid of slums would cost money as would building better housing. So they lacked any selfish insentive to better the lives of the poor, and therefore health. They were only forced to act after the 1848 cholera epidemic and so made the Public Health Act of the same year.
How many people died in the 1848 Cholera epidemic.
60000 people died of Cholera
What happened in 1854?
20000 people died of cholera and Snow concludes his investigation, linking dirty water to Cholera spread
700 people in Soho died of Cholera
What happened in 1858?
Parliment had to move from Westminster because the unusually hot summer meant the stench from the River Thames (full of human waste) was too bad to bare
What did the Great Stink cause?
The stench, and Cholera, forced the gov. to do something about these public health problems and so were going to redesign London’s sewers
Who is Joseph Bazalgette?
The man the gov. hired to redesign London’s sewers
What happened in 1866?
5000+ died of cholera in the area of London not connected to Bazalgette’s sewers, proving Snow’s theory
What happened in 1867?
all men over 21 who owned property/ paid rent higher then 10 pounds per year could vote
Meaning the gov. now had to fulfil the wishes of people impacted by poor living conditions, which meant they had to try to improve living conditions
Despite most working men being able to vote, what did Parliment focus on?
1850s
Focused on pay and workers rights rather than health but thses in turn would improve the standard of living and therefore the standard of public health
What did Charles Booth do?
During the 1850s, Charles Booth who mapped out London to show that the areas of poverty also had worst health
Who were the Rowntree family?
Rowntree family did a similar investigation to Snow and Booth, and the results caused public outcry but the gov. but, people didn’t want to pay more taxes to fix these problems
Who discovered Penicillin?
Alexander Fleming (a Scottish scientist)
1914-1918, what did Flemming do?
Flemming, a bacteriologist at St Mary’s hospital, treated soldiers from the war. He researched ways to stop infections of wounds
What does Flemming do in 1928?
Flemming discovers that penicillin can kill harmful germs like Staphylococcus after leaving some equiptment out while he was on holiday
He conducts experiments and publishes his results but never tests it on infected animals, leads to lack of enthusiasm to discovery
What was researched in the early 1930s?
Two scientists, Howard Florey and Ernst Chain research natural substances that can kill germs and come across Flemming’s research
What was the penicillin development in 1939?
Cain and Florey are given 25 pounds from the gov. to continue penicillin research and manage to develop some penicillin to treat 8 mice
What was the penicillin development in 1941?
Cain and Florey collect enough penicillin to use on one humen. They treat an infected man and worked at first but they ran out of penicillin and he dies
After the development in 1941, what does Florey do?
Goes to America and US gov. produce enough penicillin to treat 100 patients in 1943
What was the penicillin development in 1945?
US and Britain work to make enough penicillin to treat 250,000 people a month.
What was the penicillin development in post WW2?
The success of the super drug leads to huge gov. investment in medical research. Companies make millions developing the drug and start the pharmaceutical company.
What were the things impacted by WW1?
- Mental health
- Blood transfusions
- Infection
- Plastic surgery
- broken bones
- x rays
How was mental health impacted by WW1?
- British army refused to believe that shell shock existed and men with it were treated as cowards
- officially recognised PTSD in 1980
What was the impact of WW1 on blood transfusions?
- Many people still died since the stored blood clotted quickly
- Done successfully in 1900s and Karl Landsteiner discovered blood groups
- 1914: Albert Hostin discovered that glucose and sodium nitrate stopped blood from clotting when stored and other advances
How was plastic surgery impacted by WW1?
- Harold Gillies, a London-based army doctor, led to the development of plastic surgery, when reconstructing damaged faces
- Set up a special unit to transplant skin and treat men suffering from sevre facial wounds, treating 5000 by 1921
How was infection impacted by WW1?
Infections like gangrene were common and through trial and error they found the best way to prevent disease was to cut away infected flesh in saline solution
How was treating broken bones impacted by WW1?
- Army leg splint (or Keller-Blake splint) was developed and was the prototype for modern splints
How were x rays impacted by WW1?
- Discovered in 1895 and hospitals were using them to find broken bones
- mobile x rays were used to find caged bullets without cutting soldiers open
- x ray machienes, while dangerous for radioactivity, began to develop thanks to Marie Curie
How were blood transfusions impacted by WW2?
- Advances in storing blood in the years after WW1 meant blood could be kept fresher for longer
- Led to the British National Blood Transfusion Service opening in 1946
- Large blood banks were developed in both the USA and Britain
How was heart surgery impacted by WW2?
- Heart surgeon Dwight Harlen was stationed in London and performed the first open heart surgery to remove bullets and bits of sharpnel from a soldier
- His performance helped to develop heart surgery after the war
How was the NHS impacted by WW2?
- 1942: a civil servant called William Beveridge proposed a free National Health Service for all
- Just after WW2, the Labour gov. set up the NHS
How was the Plastic Surgery impacted by WW2?
- Ardibald Mclnode was a doctor from New Zealand and used drugs like penicillin to prevent infection when treating pilots with facial injuries
- His work reconstructing faces led to plastic surgery
How was diet impacted by WW2?
- Shortages of food during the war meant that the gov. encouraged people to grow their own food
- Improved the diets even of the poor s people would grow and introduce veg. into their diets
What was the impact of hygiene and disease in WW2?
- Britain’s fighting fit posters were produced to encourage people to keep healthy
- Warned against the dangers of poor hygiene
- A national immunisation programme against diptheria was launched
What was the impact of drug development in WW2?
- Penicillin was developed in the years leading up to the war
- British and American gov. realised how important this new ‘wonder drug’ could be in wiring injections in deep wounds
- 1944: enough penicillin was produced to treat all the allied forces in Europe
How was poverty impacted by WW2?
- Children evacuated in WW1 had healthier lifestyles and improved health
- Highlighted the levels of poverty so the gov. had increased pressure to improve lifestyles
How was technology impacted by WW2?
- Improved anaesthetics led to more complex surgeries
- There were also better antiseptics and new drugs to stop rejection in bodies
- Keyhole surgery developed, meaning operations could be done through small cuts
- Microsurgery let them magnify to re-join nerves and blood vessels
- Radiotherapy used to treat cancer
- 1987: the first surgery using lasers used to treat skin conditions, help clear blocked arteries, remove tumors and control bleeding
What did Booth find in 1800s?
Reports of Charles Booth, called Life and Labour of the People in London and found that 30% of Londoners were so poor that they didn’t have enough to eat property, despite having full-time jobs
He stated that there was a link between poverty and a high death rate
What did Rowntree find about 1900 public health?
Rowntree did A Study of Town Life (1901) found that 28% of the population did not have tha min. amount of money to live on.
Feuled fears that the unhealthy state of Britain’s workers could lead to the decline of the century as a great industrial power
What conflict happened in 1899 and how did this affect Public health?
- A large scale army recruitment campaign took place to find men to fight in Boer War but 40 out of 100 young men who volunteered were unfit to be soldiers
- Gov. set up a special comitee to enquire into the Physical Deterioration of the People
- 1904: the comittee released its report and acknowledged that many men were faliling to get into the army because they lead such unhealthy lives
What happened in 1906?
the School Meals Act allows councils to provide school meals with poor children getting free meals
By 1914, over 158000 children were having a free school meal everyday
Describe the early NHS.
- NHS covered dental, local doctors and specialists etc.
- Street cleaning and sewers were public services
- school leaving age was raised
- weekly allowance to cover childcare from NHS
- all over 21 could vote in 1928
- under Labour gov. of Clement Atlee
- Health service paid through taxes and insurance
- benefits were introduced for poorest
What happened in 1907?
the gov. told all councils that they should have a school medical service and the gov. paid for school clinics to be set up with free treatment
special schools were set up to teach young women about the benefits of breast feeding, hygiene and childcare
What happened in 1908?
the Children and Young Person’s Act made children protected persons and meant that parents were breaking the law if they neglected their children
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How did poverty and housing change in 1900s?
- A National Insurance Act intorduced unemployment benefits (the dole), was free medical treatment and sickness pay
- Old Age Pensions were introduced and Britain’s first job centres were built
- The building of back-to-back housing was banned
- 1918: local councils had to provide health visitors, clinics for pregnant women and day nurseries
by 1930, a huge slum clearance programme began
How did social reforms impact 1900 public health?
- Infant mortality began to drop during 1900s
- A boost to children’s welfare was given in the 1940s with the introduction of the welfare state (NHS)
- Pregnant women were given free treatment and all hospital care and nursing are free
- When a baby is born, it gets cheap milk, food and vitamins and then free education, school meals, dental treatment and daycare
- If the child is bron with a disability, it will cost the parents nothing