Public health 19 century Flashcards
3 major issues regarding health in London
Overpopulation leading to crowding, poverty, and human faeces
Who was Edwin Chadwick
A lawyer involved in working households who wrote the sanitary condition of the labouring population of great Britain.
What did Chadwick argue in his report
- That slum housing, inefficient sewerage and impure water supplies were causing the deaths of around 60,000 people a year.
- Middle class people lived longer and healthier lives because they could afford to have their sewage removed and for fresh water to be piped through their homes .
- Private companies that removed sewage and supplied fresh water were inadequate and that these services should be provided for by the government via a completely new sewage system.
Why was Chadwick opposed?
1.Many MPs support laissez-faire , therefore were against government involvement that Chadwick was proposing.
2. Some believed his link between poor sanitation and disease was invalid.
3.Private companies that supplied water would lose money if government became in charge of it.
4.Rich householders worried about increased taxes to pay for Chadwick’s ideas.
5.Arrogant and very stubborn, some just didn’t like him.
What did the 1848 Public Health Act do?
After threat of incoming cholera epidemic:
Set up a General board of health for a 5 year term run by 3 commissioners including Chadwick.
They allowed town to:
Set up their own local boards of health.
To appoint a medical officer.
Organise removal of rubbish.
Build a sewer system.
Why was 1848 Public Health act not very successful?
1.The act was passed too late to stop the impending cholera epidemic.
2.’Allowed towns to’ Didn’t actually enforce any laws so many just didn’t change anything(especially those who opposed Chadwick).
3.Overall act was very vague and didn’t actually do much, what it did not being done very well either.
1866 Sanitary Act
1.Allowed councils to improve drainage and sewerage for poor quality houses.
2.Compelled councils to locate and address nuisances to public health (very vague though and often ignored.)
1875 Public Health Act
Councils compelled to:
1.Charge taxes to appoint a local board of health.
2.Appoint medical officer in charge of health and inspectors to ensure improvements were being made.
3.To provide and maintain safe water supplies and sewers.
4. Regulate housing ensure good standards regarding dampness and overcrowding.
5.Provide street lighting and paving to keep the streets clean.
6.Check quality of food on sale.
What was the great stink and what were its impacts?
During summer of 1858 the river Thames dried up, exposing rubbish and excrement along its banks resulting in a terrible smell.
Proximity of stink to parliament resulted in a bill being rushed through pledging 3 million pounds to the building of a new sewage system.
Joseph Lister:
Inspired by Louis Pasteur’s work to research and develop the antiseptic carboxylic acid 1866.
Worked to reduce infection around wound as it killed harmful microorganisms.
Opposition/negatives of carboxylic acid
Many people did not believe that microbes were caused disease.
Infection rates did not always improve as many did not apply Lister’s methods correctly.
The acid smelled terrible and could cause blisters and soreness on hands.
John Snow
Physician who identified cause behind cholera disease.
Noticed a correlation between those infected and those who collected their water from a pump in broad street.
Upon removing the pump, cholera deaths in the area dropped.
Cholera spread through mixing of human faeces and water sources.
Robert Koch
Found rod bacteriology (study of microbes)
in 1875 found the microbe that caused anthrax.
discovered microbes causing TB in 1882 and cholera in 1883.
Used chemical dyes to easily see and identify certain microbes under a microscope.
Essentially worked to prove Pasteur’s germ theory.
Aseptic surgery
Robert Koch developed the steam steriliser which used steam to kill microbes.
This allowed surgical equipment to be cleaned resulting in more sterile conditions.
worked alongside Lister’s antiseptic method (carbolic acid) to reduce infections and death rates in surgery.
Gustav Neuber worked to combine both Koch and Lister’s ideas to devise a method under whch germs were removed from the whole operating theatre pre surgery
James Simpson
Used ether to begin with as an anaesthetic.
Summer of 1847 experimented with different substances and found that chloroform was by far the more effective anaesthetic.
Had limited side effects than ether.
Simpson began to use it in surgeries and child births, and other doctors followed.
Suffered major opposition as ‘childbirth should be painful’ and as it seemed to lead to more deaths as doctors attempted complex surgeries now that their patients were complexity unresponsive ‘black period of surgery’.
Florence Nightingale
Her along with 30 other nurses sent to a hospital in Scutari to help improve the terrible conditions soldiers faced in the crimean war.
Their efforts helped reduce the death rate from 40 percent to 2 percent.
Her methods included:
Cleaning wards and equipment
Separate beds for each patients with space between them
ventilation in wards by keeping windows open.
Setting up a clean water supply
frequently cleaning wounds and dressings.
Florence Nightingale impacts:
Methods widely adopted across England as word got around and she published books detailing her time in Scutari.
Inspired thousands of women to become nurses.
Women in medicine became more well-respected.
