The effect of urbanisation
It may be harsh to say so, but to the modern eye medical practice in the early 1800s looks pretty medieval. Harsh, because the 17th century had seen important breakthroughs in the fields of pathology, obstetrics and vaccination that would be built upon in the next century.
The foundations were laid, but there was more to be done. Medicine in 1800 was a scary combination of chance and quackery that Blackadder would have found familiar. Macbeth-like medicines were overwhelmingly botanical, with preparations of mercury, arsenic, iron and phosphorous also popular. Doctors might recommend a 'change of air' along with vomiting and laxatives and those old favourites, bleeding or leeches. The power of prayer was regularly used. All in all, not ideal. Yet a century later medicine would be available in a form easily recognisable to anybody today: hospitals, stethoscopes, white coats and x-rays. What happened?
Two things. Together, cities and science forced real progress in both prevention and cure. The Industrial Revolution was in full flow, and the invention of the steam engine meant that factories could go anywhere, not just near natural power sources. They went to the towns and cities. At a time when Britain's population was increasing rapidly (from six million in 1750 to nine million 50 years later), cities were expanding even faster as now redundant farmworkers migrated to the nearest town to find work. Preston grew sixfold between 1801 and 1851, Bradford and Glasgow eightfold. They were not alone.
'Overcrowding combined with poor sanitation and often grinding poverty to leave many vulnerable...'
This growth had enormous consequences. Death rates were high, and far worse in cities than in the countryside. Smallpox, typhus and tuberculosis were endemic, and cholera alarmingly epidemic. Overcrowding combined with poor sanitation and often grinding poverty to leave many people vulnerable to the latest outbreak of anything nasty. Luckily, the Victorians loved statistics, and these validated the emotive prose of Dickens, Gaskell and Engels. In 1832 Parliament agreed to an official inquiry into the operation of the Poor Laws. Sir Edwin Chadwick was energetic in establishing the links between poverty and disease, and the enquiry resulted in new Poor Laws in 1834. Yet these did not go far enough and continued work resulted in the Public Health Act of 1848, which set up local health boards, investigated sanitary conditions nationwide, and established a General Board of Health.
Published: 2002-02-01
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