History of Medicine Factual Knowledge sheetHEALTH WARNING: this is the basics. If you want better marks, you need to go further than this!Public Health (1350-2000)Medieval1. Sewage. Beginning to be dealt with by individuals and local councils. Gutters in roads, rakers toclean up waste in streets, separate areas to slaughter animals, public latrines, open sewers,disposal of waste in rivers, fines for littering. But haphazard and piecemeal.2. Clean water. Beginning to be dealt with by individuals. Water sellers, conduits, rules that wellsmust be dug away from cess pits. But haphazard and piecemeal.3. Living conditions. Poor – crowded and badly planned housing in towns, low quality materials.4. Diet. Poor – poverty prevented many people accessing a balanced diet. Deficiency diseases –scurvy, rickets – common.5. Access to health care. Poor – doctors and medicines expensive. Home treatment the norm.6. Education about health. Poor. Ordinary people had no way of accessing medical knowledge.Renaissance1. Sewage. Still being dealt with by individuals and local councils. Brick drains for richest, invention ofWC (although it didn’t catch on). Small and piecemeal.2. Clean water. Beginning to be dealt with by individuals. Attempts to supply London with fresherwater via fake rivers, setting up of pumps in streets but water straight from polluted rivers, watercompanies taking over supply of water.3. Living conditions. Poor – crowded and badly planned housing in towns, low quality materials.4. Diet. Poor – poverty prevented many people accessing a balanced diet. Deficiency diseases –scurvy, rickets – common.5. Access to health care. Poor – doctors and medicines expensive. Home treatment the norm.6. Education about health. Poor. Ordinary people had no way of accessing medical knowledge.Industrial1. Sewage. Government building of the London Sewers (1850s-60s) led to rest of country gettingsewers after the Public Health Act 1875 made sewage disposal mandatory. Treatment works andpumping sewage well out of the way. Increasing numbers of houses connected directly to sewagesystems. Refuse collection started.2. Clean water.John Snow made link between polluted water and cholera in 1850s but ignored tillbolstered by Germ Theory. 1875 Public Health Act made clean water supply mandatory.Reservoirs of clean water in place by end of 19thcentury and pumped to taps (either in houses or instreet).3. Living conditions.Very poor at start of industrial revolution when people crammed into slums.Getting slowly better at end of 19thcentury as laws were made to improve housing and build newhouses to higher standards.4. Diet.Improving as new industrial transport allowed fresh produce into the cities easily. However,poverty prevented all accessing a good diet.5. Access to health care. Poor – doctors and medicines expensive. Home treatment the norm.
6. Education about health.Low. Compulsory education of children to age of 11 meant some basicknowledge of hygiene beginning to be passed along.20thcentury1. Sewage. Pretty much completely sorted throughout the century. Improvements made as andwhen. Education for people on how to stop sewers being blocked.2. Clean water.Pretty much completely sorted throughout the century. As new houses built, housesdirectly connected to water supplies.3. Living conditions.New housing after WW1 (Homes for Heroes) and after WW2 (repairing Blitzdamage). Slums gradually disappearing. All drains covered. Gardens and parks increasinglycommon.4. Diet.Better wages and cheaper food. Wider range of products as transport allows more food fromabroad. Competition of supermarkets to keep prices down.5. Access to health care.National Insurance Act 1911, NHS 1946 – free for all, NHS today still existsalthough imperfect.6. Education about health.Compulsory education for all children to 14, then 16, then 18 – moreknowledge, propaganda campaigns in WW2, information campaigns in second half of century –AIDS, smoking, healthy eating, information available via TV and internet – reaching wider audience.Key people to know about1. Edward Chadwick. Government adviser on public health who wrote 1842 report, leading to 1848Public Health Act.2. John Snow. Surgeon who worked out how cholera was spread.3. Aneurin Bevan. Minister for Health who set up the NHS.Factors pushing medicine on or holding it back1. War. WW1 and WW2 improved housing, and affected people’s ideas about who should haveaccess to healthcare.2. Government. Laissez-faire until 19thcentury, but then gradually took a greater interest in thepublic’s health (particularly as it became a vote winner).3. Scientific knowledge. Germ theory helped people do more accurately and efficiently. Newmedicines allowed more effective control of disease.4. Communication. Use of propaganda, access to TV and internet made spreading of public healthinformation quicker.5. Social attitudes. Changing views that all people should have access to health care – philanthropistsin 19thcentury, charities, Liberal Government (1906-12), effect of WW2, Labour government(1945).Exam board specifications highlight:Changes to water supplies and sewage from 1350, changing nature of public health provision,changing role of government in tackling public health, how industrialisation put pressure on publichealth, how new industrial technology helped public health, cholera, 1848 and 1875 Public HealthActs, Liberal Health reforms (1906-14), NHS.