Poverty: Breadth 1: The Impetus for Public Health Reforms

• The Rising Population:

  The death rate decreases due to: the smallpox vaccine, better quality and quantity of food, cheaper soap which is more readily available etc.

  The marriage rate increases due to: farmers employing less live-in servants, unskilled workers replacing skilled craftsmen, resulting in earlier marriages and therefore more babies.

  Civil Registration (of births, deaths and marriages- 1837) showed a young, fertile and actively reproducing population in most urban centres. However, it also showed in Manchester (1840s) 57% babies died before their 5th birthday.
• Housing:

  Bad housing has existed since the medieval times. The industrial revolution has led to overcrowding, making conditions even worse.

  Urban places have responded by adapting 'vacant' living space and buildings to create more dwellings. This meant that it was a floor or even a room per family, including the cellars and attics. For some, these rooms were also their workspace.

  The working class tended to live closer to factories/mills, due to the lack of public transport, however the upper classes perferred the outskirts and countryside.
• Sanitation:

  For the first half of the 19th century, houses lacked drainage, sewerage and a regular water supply.

  Privies were often located outside in courtyards and alleys, where they were emptied into cesspits and collected in dunghills before being sold to farmers.

  Drinking water was also in short supply, with it being controlled by water companies. These companies sometimes used reservoirs and springs, but mostly used local rivers. On top of this, supply was often irregular and the poor had to use standpipes, where they queued with buckets whenever the companies turned the water on.
• Measles: A highly infectious viral infection that can affect the lungs and brain.
• Typhoid: A bacterial infection that can become fatal if left untreated. It affects multiple organs and spreads through the body.
• Diphtheria: A potentially fatal contagious bacterial infection that spreads through coughs, sneezes, and close/prolonged contact.
• Tuberculosis (TB): A bacterial infection that spreads through inhaling tiny droplets from coughs and sneezes. It primarily affects the lungs.
• Scarlett Fever: A bacterial infection that mainly affects children and is highly contagious. It causes a pink-red rash.
• Cholera: A fatal bacterial infection caused by contaminated food and water. It can lead to dehydration through symptoms like vomiting and diarrhea.
• Miasma Theory of Disease: Although people understood the link between dirt and disease, they didn't know what the link was, leading to the popular explanation of miasma (bad air). This miasma was assumed to be poisonous gas made of particles of decaying matter that carried disease.
• Germ Theory: Due to the development of microscopes (due to Joseph Lister), scientists could see micro-organisms, leading them to assume that these germs where the result of a disease, not the cause. They called this spontaneous generation.

  However, in 1861, Louis Pasteur conducted experiments to prove that micro-organisms existed in the air and were therefore not created by decaying matter and instead caused disease. Not everyone believed Pasteur until Robert Koch and his team identified the specific germs of most killer diseases in the 19th century during the 1880s/90s.
• There were 30 recorded riots in Britain during the Cholera Epidemic of 1832, in towns and cities such as Birmingham, Leeds and London. These riots were not directed at the authorities for failing to contain the epidemic and were instead fuelled by fear.
• The Liverpool Riots: From the 29th May to the 8th June 1832, 8 major riots occurred in Liverpool due to locals rioting against local medical men. This was because they thought cholera victims were being taken to hospitals to be used for body dissections. They had evidence to this belief as in 1826, 33 bodies had been found on the Liverpool docks to be shipped to Scotland for dissection and only 2 years later, a local surgeon was tried for running a grave robbing system, to provide bodies for dissection. The riots only ended due to pleas from the local clergy, and trusted doctors.
• Exeter Riots: In Exeter, the local authorities created regulations for the disposal of cholera-infected corpses. People objected to the burial of these cholera victims in local graveyards, due to them being buried without the proper religious ceremonies.
• In 1831, the government sent 2 medical commissioners to St. Petersburg, Russia, to assess the outbreak of cholera. They suggested the creation of a temporary Board of Health.
• The temporary board of health advised local governments to set up their own boards, and to appoint district inspectors to inspect the local conditions. They also issued advice, such as: houses were to be white-washed and limed, infected furniture and clothing was to be fumigated, those who are infected should be quarantined, food and clothing to be given to the poor, and the introduction of temporary fever hospitals.
• In 1832, the government also set up temporary Cholera Acts, so that local authorities could enforce some local measures, and so they could finance these measures. This, among other things, was significant as it meant that for the first time, the government was recognising cleanliness meant good public health.
• Some problems with the government's action in the Cholera Epidemic of 1832 included the idea that the things introduced were only temporary, and would be disbanded after the epidemic. Furthermore, district inspectors merely gathered information, they didn't discover a prevention or cure to cholera.
• Two theories for the spread of cholera included the Contagionist Theory and the Miasmic Theory. The Contagionist Theory suggested that cholera spread through contact, but many argued this wasn't true as not all members of a household became ill with the disease. The other theory, the Miasmic Theory suggests that it is caused by miasma, which many more agreed on. Although this wasn't correct, it did lead to some helpful measures, such as the removal of heaps of excrement.
• There were many 'cures' for Cholera. Most included Patent Medicines, such as Moxon's Effervescent Universal Mixture, Daffey's Elixir and Morrison the Hygienist's Genuine Vegetable Universal Mixture, which all claimed to cure Cholera. Prayer was also suggested by the church. Furthermore, the Lancet (a journal by doctors, for doctors) in 1831, reported that Jews in Wiesniz avoided cholera by rubbing themselves with an ointment made of things such as crushed beetles, wine and vinegar.