Public Health: Phase 2 Dealing with Cholera 1848-1860 Flashcards
What was the problem of cholera by 1848?
Cholera was one of the most feared infections of the Industrial Age.
- Symptoms included vomiting, cramps, eyes sinking and your skin turning black/blue
- You could be dead within 24 hours
- Cholera was a disease of both rich and poor.
When and where did cholera arrive?
1831 in Sunderland. It killed around 30,000 people within a year.
The majority of these deaths were in overcrowded slums with poor housing and little clean water.
What did MPs discuss during the 1848 cholera outbreak
A day of prayer
What did Dr Robert Baker’s report on the 1832 epidemic in Leeds describe the housing as
- Many of the streets were on bare earth and so mud and filth collected easily
- 19 streets did not have a sewer and another 10 only had a sewer covering part of the street
- Stagnant water caused offensive smells
- In some poorer parts of town, human excrement was collected to sell to farmers.
Who was Edwin Chadwick?
He was born in Manchester in 1800
He trained in law
He worked for the Poor Law Commission and believed in using science for social improvement.
1832 - Asked to serve on a royal commission to investigate the effectiveness of poor laws.
He became interested in the problem of sanitation and was a believer in miasma theory.
He believed that cleaning, drainage and ventilation would make people healthier and therefore less dependent on welfare.
This work contributed to the 1834 Poor Law Amendment Act
What was Chadwick’s 1842 report about?
He published ‘The Sanitary Conditions of the Labouring Population’ which showed that there was a direct link between poor living conditions and life expectancy and disease.
He said that the labouring classes could not labour as well as it could because of poverty and poor health
He argued that if you improve the standard of living for the working class then the country would benefit as a whole.
MPs listened to this report in ‘astonishment, dismay, horror and even incredulity’
What did Chadwick’s 1842 report inspire
It inspired the Public Health Act of 1848
Why was Chadwick’s report important?
He realised the poor were living in poor conditions which led to illness.
He came up with a solution - improving drainage and sewage, removing waste from the streets, introducing clean water supplies and appointing medical officers
He was hard working so he gathered lots of evidence
His report was the basis of the 1848 Public Health Act
What is the 1848 Public Health Act?
- Influenced by Chadwick’s 1842 report and triggered by a major epidemic of cholera
- It was permissive - the Board of Health would encourage local authorities to improve conditions if their ratepayers supported it but could not force them
- Provide a local medical officer
- Enabled local authorities to borrow money to pay for the improvements
- Disbanded in 1878
What were the limitations of the 1848 Public Health Act?
- It was permissive. Local authorities were not forced to make change.
- It was temporary. The Board of Health was only set up for 5 years.
- Cost of improvements was high. £11 million was borrowed between 1848-1872 but only a few local authorities took measures to improve conditions
- Chadwick’s personality. He annoyed people and did not win support. He was arrogant and refused to believe Germ Theory.
- Attitudes were slow to change. People did not like the idea of increased taxes
- By 1872, only 50 councils had appointed Medical Officers of Health.
Who was John Snow?
He was a pioneer in surgery, public health, improving medical conditions and the use of evidence to challenge old theories.
At fourteen he became an apprentice to a surgeon
How does Snow formulate his theory of how cholera is spread?
- He dealt with cholera in 1832 in Killingworth. The poor sanitation did not escape John Snow’s observation.
- He settled in London and began to study cholera
- He began to believe that cholera was spread by something other than poisonous vapours - if it was surely it would affect the lungs.
- He believed that London’s dirty and polluted water supply had something to do with it. That Londoners were drinking their own waste.
- He published ‘On the Mode of Communication of Cholera’ in which he outlined his theories.
- Many rejected these ideas.
How does John Snow use the 1854 cholera outbreak to prove his theories?
- He used research, observation and door-to-door interviews to build a detailed map of a cholera epidemic in Broad Street
- Nearly all the deaths had taken place within a short distance of the water pump
- Near to the pump, there was a brewery and none of the people there had cholera. The brewery had its own water pump and the men had free beer.
- Snow removed the handle from the Broad Street pump
- There were no more deaths. It was later found that a cesspool near the pump had been contaminating the drinking water
- Snow put pressure on water companies to clean up their supplies.
What limitations were there to change during this period?
- Little was done to improve public health, even with Snow’s findings.
- MPs refused to debate the issue because the idea of consuming human waste was too disgusting and embarrassing to consider.
- Miasma theory was still incredibly popular - Germ Theory had not been discovered
- There was still an idea that people were being punished for their sins. Reverend Henry Whitehead was a key proponent of this idea.
