3.1 The Impetus for Public Health Reforms

• Why did reforms to public health become such a pressing issue from c1780?

  - No drains or sewerage systems

  - No effective measure to prevent spread of disease

  - Period outbreaks of disease

  e.g. Bubonic Plague
• What was the Bubonic Plague?

  Highly contagious disease

  spread by fleas that lived on rats
• Between 1781 and 1971, how much did the population grow?

  13 million to over 31 million
• What was the most rapid period of growth?

  Between 1811 and 1841
• Why did the death rate fall?

  - Vaccinations that prevented smallpox

  - Agricultural industry producing better food

  - Chemical industry producing cheap and readily available soap

  - Textile industry producing cotton cloth, easy to watch because it was cheap.
• Why did the birth rate rise?

  - Fewer people dying, had children in their twenties

  - More babies lived to adulthood
• Why did the marriage rate rise?

  - Farmers employed fewer live in servants

  - Industrial workers could marry as soon as they had a job

  - No contraception
• When was Civil registration introduced?

  1837
• Who was William Farr?

  Qualified doctor that was interested in medical statistics
• Give examples of 'filth diseases'.

  Typhoid, Diphtheria, TB, Scarlet fever, Cholera
• When was the germ theory of disease developed and by who?

  1867 by Louis Pasteur
• What were the main causes of disease in the early 19th century?

  - Overcrowding

  - Lack of sanitation

  - Lack of clean water
• When were the typhus epidemics?

  1837 and 1839 and 1847
• When was Cholera's massive 4 epidemics?

  1831-32

  1848-49

  1853-54

  1866
• How many people were killed in the first cholera epidemic?

  31,000
• How many people were killed in the second cholera epidemic?

  62,000
• What is typhus caused by?

  Rickettsia bacteria
• What are the stages of typhus?

  - Flu-like symptoms

  - Rashes over body

  - Coma or death
• What were the two main theories about cause of disease?

  - Miasma

  - Germ theory
• What instigated the germ theory?

  Development of microscopes by Joseph Lister
• Who was the doctor that identified germs as the main cause behind killer diseases?

  Robert Koch
• Why did cholera epidemics had a profound effect more than endemic diseases?

  - High percentage of fatalities

  - Speed with which cholera could strike
• What were the 30 riots in towns and cities called?

  Cholera-phobic riots
• What were the 'cholera-phobic' rights rioting against?

  Local medical men
• When was the Board of Health set up?

  1831
• When was the temporary cholera acts put up?

  1831
• When was the Board of Health made permanent?

  1848
• How is cholera caught?

  By swallowing water or eating food that is infected by cholera
• What was the name of Chadwick's report?

  Report on the Sanitary condition of the labouring population of Great Britain, 1842
• Why was Chadwick's report significant?

  - Linked public health and poor law

  - Attacked inadequacy of water supply
• Who were woolcombers?


  Person who combed fleeces to straighten the fibres.
• When and who invented the S-Trap?

  Alexander Cummings, 1775
• Who developed the first trap wc?

  Thomas William Twyford
• Who invented the system of flushing gates?

  John Rue in 1842
• What was Chadwick's idea to do with waste?

  Spray onto fields as fertilisers
• When was the sewage treatment system developed?

  1912
• Give examples of waterworks companies.

  - Lambeth

  - Southwark

  - Chelsea
• Why did attitudes to public health reforms change?

  - Raising social concerns: Writers, journalists, artists

  - Economic imperatives
• What did governments set up in 1843?

  Royal commissions to investigate living conditions of poor
• What was established in 1844?

  Health of Towns Association