Key Individuals - 19th Century Public Health

John Snow

  • In 1854, there was a British cholera epidemic. Cholera was a fatal water-borne disease which rapidly killed its victims through dehydration and diarrhoea.
  • Suggested causes were miasma, contagion and God sending the disease to punish sinners.
  • John Snow was a London doctor who speculated that the illness was spread through contaminated water. This idea came about as he mapped out the death statistics accross London and found most to be centred around the Broad Street water pump, in Soho.
  • He hence convinced the local council to remove the pump's handle; to subsequently result in the death rate being reduced to a considerable extent. 
  • Still, not all held faith in what Snow was suggesting. This was a time prior to germ theory's 1861 publication; and hence the population held no knowledge of the existence of germs. Thus, there were those that conservatively clung onto the concept of spontaneous generation. 
  • Another interesting element of Snow's work to note in that he was one of the first doctors to use ether and chloroform. He demonstrated successful use of the latter anaesthetic in using it upon Queen Victoria as she gave birth to two of her children. 
  • The Father of Modern Epidemiology
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Edwin Chadwick

  • Chadwick was a social reformer and lawyer. He then became the first president of the Association of Public Sanitary Inspectors in 1884; to later be renamed as the Chartered Institute of Environmental Health. 
  • In 1842, he published his 'Report on the Sanitary Conditions of the Labouring Population'; which expressed his concerns surrounding the health of the poor. It is thought to have been partially motivated by the London investigation into the living conditions of the poor by Doctors Arnott, Kay and Smith in four years prior. This nationwide investigation proved that the poor of Britain were constrained to unsanitary, cramped living conditions. His main concerns lay at the facts that the poor were often suffering from illness caused by their living conditions, to subsequently become poorer due to forced absence from work - whilst the care for the ill poor would increase the taxes of ratepayers. 
  • He therefore suggested that the most appropriate solution would be to provide public health facilities for the poor; through clean water supplies, sewers, drainage, street cleaning and medical officers to supervise this. These could be funded through loans; repayable within thirty years through increased rates. 
  • This formed the basis of the 1848 Public Health Act; though this didn't actually come about until six years after the report's publication, due to strong initial opposition. The wealthy held no desire to fund systems of such little use to them; whilst further issues were the attitudes of the local authorities - as they detested the interference of the central government, whilst certain MPs supported the laissez-faire concept.
  • Nevertheless, the government was forced into action as a result of a cholera outbreak which hit Europe in 1847.
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William Farr

  • In the early nineteenth century, the British government wished to keep a record of its citizens; and hence it became a legal requirement, from 1837 onwards, for all deaths, births and marriages to be recorded.
  • William Farr was given the duty of registering them. Upon having investigated into the deaths recorded - analysing the causes and places - he managed to establish a link between poverty, dirt and disease.
  • This in itself shamed some councils into action. 
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Joseph Bazalgette

  • The Great Stink took place in London in the summer of 1858; as the Thames' tide levels were notably low, to result in the stench of sewage lingering in the air. This motivated the government to act; it proved that the 1848 Public Health Act hadn't done suffice, and the MPs were particularly affected in that the Houses of Parliament lie on the river's banks. 
  • Joseph Bazalgette was to then design a revoluntionary sewage system which would act as a solution to the problem. The Italian engineer, in light of the fact that construction was to take over a decade, anticipated continued population growth; and so accounted for this by increasing the capacity of the sewers.
  • The sewage system was over 1000 miles in length, and constructed from contemporary materials - such as Portland cement. 
  • Bazalgette used an innovative design in making the tunnels ovular, as opposed to circular; in order to ensure that the sewers were self cleaning. 
  • He meticulously mapped the tide trends of the Thames to ensure that the sewage would be flushed away. It was also connected to pumping stations so that it could be deported out to sea. 
  • Overall, London's new sewage system was a success - it's even still in partial use today. 
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Octavia Hill

  • Hill was a teacher and social reformer that derived from a family committed to social reform. In her teaching years, she had been given powerful insight into the dreadful living conditions of poor pupils. 
  • She campaigned for the improvement of the living conditions of the poor. In 1865, she began purchasing slum houses and converting them into health homes - to show what could be done to improve matters for the poor. This significantly contributed towards the 1875 Artisans' Dwelling Act - which involved the demolishment of slums in the interests of public health.
  • She was additionally a strong believer that all should be allowed access to public spaces. She campaigned against building upon woodland - like Hampstead Heath - and was one of the co-founders of the National Trust.
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I guess you could say these flashcards are  s i c k

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