WHY?

Extract from Dr John Snow’s Mode of Communication of Cholera, 1854

The most terrible outbreak of cholera which ever occurred inKingdom took place in Broad Street (London) a few weeks ago.There were upwards of five hundred fatal attacks of cholera In ten days. A great number of cases died within a few hours Of each other.

I found that nearly all the deaths had taken place within a short Distance of a particular water pump, in five of these cases they Told me they always used the Broad Street pump. In the other Cases it was children who went to school near the pump in broad Street.

I conclude that the deaths from cholera are due to the evacuations (faeces and urine) finding there way from patients already infected With the disease, into the drinking water collected from the pump In Broad Street.

Deaths Dispensary

From Edwin Chadwick’s Report

Epidemic diseases are caused by decaying animal and vegetable substances, by damp and filth and close overcrowded dwellings. The annual loss of life, From filth and bad ventilation is greaterthan the loss from death or wounds in any war

The most importance and practical steps to take are drainage, the removal of all rubbish from the street and the improvements of the supplies of water.

The expense of public drainage and supplies of water would savemoney because there would be less money spent on sickness and mortality (death).

To prevent further disease a district medical officer should be appointed for each area.

There was a terrible epidemic of Cholera, people thought it had something to do with unhealthy living conditions. They asked Edwin Chadwick to investigate

Questions

• Why were public health reforms Begun?

• Why was there opposition to public heath reforms?

• Why and how was public health finally improved?

Exam Questions

• Briefly describe the main problems of public health in the early nineteenth century (5)

• Explain why there was so much improvement in public health in the second half of the nineteenth century (7)

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