Breadth 1

Question 1

What was different in pre-industrial Britain?

Answer 1

There were few pressing public health problems.
There was low population density & limited urbanisation.

Vast majority lived, thinly spread, in rural areas.

Question 2

British population stats

1781
1871
1939

Answer 2

1781: 13 million

1871: 31 million

1939: 48 million

Question 3

What did the creation of work in factories, mills & foundries due to industrialisation lead to?

Answer 3

It led to a sudden influx of people coming to towns and cities for employment.

This forced many to crowd together in substandard conditions with little by way of clean water or adequate sanitation.

Question 4

What did the…
- Medical industry
- Chemical industry
- Agricultural industry
- Textile industry
…contribute that led to the death rate falling?

Answer 4

Medical industry produced the smallpox vaccine, preventing many deaths.

Chemical industry started to produce cheap, available soap.

Agricultural industry produced better quality and quantity of food.

Textile industry produced cotton cloth which was cheap and easy to wash.

Question 5

Why did the birth rate rise?

Answer 5

Because death at a young age became less common, meaning people had children/more children.

This followed through generations.

Question 6

What was the percentage of people living in towns in 1801, 1851 and 1891?

Answer 6

1801: 33%
1851: 50%
1891: 72%

Question 7

By 1900, how many British citizens were urban dwellers?

Answer 7

4 out of 5

Question 8

The influx of thousands and thousands of people led to the influx of what?

Answer 8

What Victorians called ‘filth diseases’.

Typhoid, diphtheria, tuberculosis, scarlet fever, cholera.

Question 9

How did urban communities respond to overcrowding?

Answer 9

By using up & adapting ‘vacant’ living space, and building new dwellings.

Cellars & attics filled with people, also used as workplaces.

Question 10

What did lacked in housing that caused problems?

Answer 10

Lack of services to a house, rather than the house itself.

Lacked sewerage, drainage & a regular water supply.

Question 11

Lavatories were usually in courtyards and alleys.
What was the waste emptied into?

Who cleaned it out & what did they do with it?

Answer 11

Waste emptied into cesspits, cleaned out (from time to time) by night-soil men.

It was collected into dunghills, then sold on to local farmers.

Question 12

Why was a water supply difficult to get?

Answer 12

Not only was it in short supply, it was expensive, controlled by vested interests (private water companies).

Question 13

What was the nature of living in the first half of the 19th c.?

Answer 13

Overcrowding

Lack of sanitation

Disease was rampant

Life expectancy was low

Question 14

What spread typhus fever?

When were typhus epidemics?

Answer 14

Body lice, which many people who were living in unsanitary, overcrowded housed.

1837
1839
1847 - killed 10k people in north-west England alone.

Question 15

Cholera hit Britain in four massive epidemics.
When were they?

Answer 15

1831-32: killed 31,000

1848-48: killed 62,000

1853-54

1866

Question 16

What were the two main theories about what caused disease in the 19th c.?

Answer 16

Miasma & germ theory.

Question 17

What technological development in 1830 allowed L. Pasteur & R. Koch to develop their germ theory?

Answer 17

1830: Microscopes - principally by J. Lister

Could magnify up to 1,000x, thus enabling observation of micro-organisms.

Question 18

Who identified the germs that caused most of the killer diseases of the 19th c.?

Answer 18

Robert Koch & his team.

Question 19

Why did cholera epidemics have such a profound effect on legislators & the public compared to other endemic diseases?

Answer 19

The high percentage of fatalities among those contracting the disease, (40-60%).

The speed at which cholera could strike.

Question 20

There were 30 recorded ‘cholera-phobia’ riots.
Why were people rioting?

Answer 20

It was not directed at the authorities for failing to contain the epidemic, but rather because people feared that bodies were being stolen for dissection for study of the anatomy.

Question 21

How did the government react to the cholera outbreak?

Answer 21

1831: sent 2 medical commissioners to Russia to assess the outbreak.

A temporary Board of Health set up after their report, who advised gov areas to set up local boards of health.

Question 22

What did the (temporary) local boards of health do?

Answer 22

Appointed district inspectors to report on food, clothing & bedding of the poor, ventilation, number of people per room.

Issued advice & introduced:
- Houses were to be whitewashed & limed, all infected furniture & clothing was to be fumigated
- Cholera victims to be put in quarantine.
- Food & flannel clothing distributed.
- Temporary fever hospitals to be set up.

Question 23

What temporary law was passed in 1832, and for what reason?

Answer 23

The Cholera Acts 1932

To allow local authorities to enforce some measures & to finance them from poor rates.

Question 24

What were the 2 main theories of the cause of cholera?

What else did people do to prevent or cure themselves from cholera?

Answer 24

Contagionist - spread through contact.

Miasmic - bad air, ‘miasma of filth’.

Religious - a punishment from God for sin.

1831, The Lancet - ointment made from wine, vinegar, camphor, mustard, proper, garlic & beetles.

There were many patent medicines which claimed to cure cholera.

Question 25

What was James Kay’s position & what report did he publish?

Answer 25

Secretary of the Manchester Board of Health The Moral and Physical Condition of the Working Classes Employed in the Cotton Manufacture in Manchester, 1932

Question 26

Why was Kay & his report significant?

Answer 26

His report was one of the first detailed reports on the condition on a group of working people. Kay was one of the first to demonstrate the connection between disease & dirt, & diet.

Question 27

Kay included the moral condition of the poor in his report. What was the implication?

Answer 27

That dirty living led to dirty habits.

Question 28

Who wrote the Report on the Sanitary Condition of of the Labouring Population of GB, 1842? What was the report based on?

Answer 28

E. Chadwick The report was based on questionnaires sent to all local boards of guardians.

Question 29

At first, why did the PLC refuse its publication?

Answer 29

Because Chadwick criticised the water companies, medical profession & local administration. In 1842, Chadwick published it under his own name, at his own expense.

Question 30

What were the 4 main points of Chadwick’s report?

Answer 30

He attacked the inadequacy of existing water supplies, drainage & sewerage systems. He linked PH & the PL. He pointed the finger at vested interests that stood in the way of improvement. He stressed the connection between these vested interests, overcrowding, epidemics & death.

Question 31

What was the reaction to Chadwick’s report, including from Sir James Graham (Home Secretary)?

Answer 31

There was a variety of reactions. Graham was reluctant to act on the findings & conclusions of what was a private and largely personal report. He set up a Royal Commission on the Health of Towns to investigate the legislative & financial side of Chadwick’s recommendations.

Question 32

What report generated in 1844 as a result of Chadwick’s report? How did the report find its findings?

Answer 32

Report of the Royal Commission into the Sanitary Condition of Large Towns and Populous Districts Questionnaires were sent to the 50 towns with the highest annual death rates, and the commissioners visited the worst areas.

Question 33

What did the Report of the Royal Commission into the Sanitary Condition of Large Towns and Populous Districts find?

Answer 33

It upheld Chadwick’s findings. 42/50 towns had bad drainage. 30/50 had poor water supplies.

Question 34

The second report in 1845 of the Report of the Royal Commission into the Sanitary Condition of Large Towns and Populous Districts contained proposals for future legislation. What did it recommend?

Answer 34

Central government be given extensive powers to inspect & supervise local sanitary work. Local sanitary districts be set up, with authority over drainage, sewerage, paving & water supplies. Also be given powers to raise money for sanitary schemes through local rates.

Question 35

In the 1840s, how many wool combers were living & working in their own dwellings? What was the average age of death of a woolcomber?

Answer 35

10,000 woolcombers were living & working in their own dwellings in the 1840s. The average age of death of a woolcomber was 14.

Question 36

What did the Bradford woolcombers form in 1845 & for what purpose?

Answer 36

A Protective Society & their own Sanatory Committee to report on their living conditions.

Question 37

What report did the Bradford Sanatory Committee publish in 1845? Did the government act?

Answer 37

Report of the Bradford Woolcombers Sanatory Committee Yes, in 1848.

Question 38

What was an important breakthrough that came in 1775?

Answer 38

A. Cummings ‘S-trap’. This sealed the toilet bowl, preventing foul air from coming up from the sewer. J. Bramah combined this invention with a float valve system for a cistern to build the first flush toilet.

Question 39

What did George Jennings & Thomas W. Twyford do?

Answer 39

George Jennings revolutionised sanitation by inventing an improved water closet, patenting it in 1852, and making it widely adopted in middle-class homes by the late 1850s. Thomas William Twyford revolutionized toilets by inventing the ‘wash out’ trap water closet in 1875 and improving it with further patents in the 1880s and 1888.

Question 40

What breakthrough came in in 1912?

Answer 40

Scientists at the Manchester University developed the sewerage treatment of activated sludge, whereby sewage was biologically treated to make it safe.

Question 41

Like the provision of sewage, whose hands was the provisions of water in for most of the 19th century?

Answer 41

Private companies. Whether or not individual companies took advantage of new technology was up to the shareholders who needed to make profit.

Question 42

Examples of companies investing in modernising water supply

Answer 42

1802 - Lambeth Waterworks - Expanded & replaced wooden pipes with cast irons ones. In 1808, West Middlesex Waterworks Company also did. 1829 - Chelsea Waterworks Company - First to install a sand filtration system to purify water from Thames.

Question 43

What was a major problem concerning water quality?

Answer 43

Water companies extracted drinking water from rivers polluted by industrial & faecal waste.

Question 44

Between 1780-1939, what factors pressurised local & national authorities to intervene?

Answer 44

A growing awareness of the nature of the problems created by poor living conditions. An understanding of the implications of various medical & scientific discoveries.

Question 45

The authorities intervention resulted in what?

Answer 45

A deeper awareness of the need for reform among the public, press & parliament. It generated a desire for further change.

Question 46

How did authors like C. Dickens & E. Gaskell affect attitudes to PH?

Answer 46

His ability to bring characters to life made PH issues, particularly in the workhouse, impossible to ignore. Serialisation of Dickens’ books. - Reached a wide audience, including those who could push actual change. Gaskell's work, like Dickens', helped to raise awareness and foster a sense of empathy among the middle and upper classes, which was essential for driving reform.

Question 47

Did Dicken’s work impact actual reforms or lead to specific reforms?

Answer 47

Yes, it helped to build a groundswell of public support for better living conditions & healthcare. E.g. ‘Bleak House’, which described workhouses & the poor sanitation, contributed to the PH Act 1848.

Question 48

How did newspapers (national & local) play a role in raising PH concerns?

Answer 48

Local newspapers (e.g. Leeds Mercury) would report on disease outbreaks, often linking them to poor living conditions. National newspapers (especially The Times) could influence policymakers. E.g. their campaign for effective sewerage in London during the Great Stink of 1858.

Question 49

How did artists contribute to raising awareness of the living conditions of the rural & urban poor?

Answer 49

The visual impact complemented the written word & helped to humanise their struggles. Artists like Sir Luke Fildes (e.g. his painting ‘The Widower’) were admired by authors such as Dickens.

Question 50

What did doctors, parishes & county councils improve in the mid-19th c.?

Answer 50

Their record keeping facilities which enabled the production of statistical evidence.

Question 51

Evidence from the report by the Medical Officer for Health, London, 1892

Answer 51

% of total pop. overcrowded 1. 15% 2. 15-20% 3. 20-25% 4. 25-30% 5. 30-35% 6. Over 35% Death rates per 1,000 1. 17.5 2. 19.5 3. 20.3 4. 22 5. 24 6. 25

Question 52

When was the Health of Towns Association established & what was the aim?

Answer 52

1844. To carry out a propaganda campaign for PH legislation.

Question 53

What did governments set up in the mid-19th c. to investigate the living conditions of the poor?

Answer 53

Royal Commissions. E.g. Royal Commission for Enquiry into the State of Large Towns and Populous Districts set up in 1843, reported in 1844.