SOME KEY EVENTS IN THE HISTORY OF PUBLIC HEALTH
IN BRITAIN IN THE 19th CENTURY

 

Sir John Pringle (1707-1782) a Scotsman, trained in Leyden and Edinburgh published in 1752 Observations on the Diseases of the Army advocating good ventilation of barrack-rooms and good sanitation. He also wrote on gaol fever which we now know as typhus.

John Ferriar (1761-1815), came from Jedburgh and studied in Edinburgh.  He moved to Manchester in 1785 and in 1790 was appointed physician and Manchester Infirmary.  He met Thomas Percival who had done an early survey of the town with Thomas Henry, the apothecary.  He became a sanitary reformer and physician at Manchester Infirmary.  He was influential in setting up a voluntary Board of Health in 1796 which recommended whitewashing of houses inside twice a year, wider streets, better location of privies, better ventilation of houses, regulation of lodging houses, measures to reduce damp in dwellings, public warm baths, street cleaning and removal of dung hills.  The board lacked the power and resources to carry through these ideas.  Ferriar published Medical Histories and Reflections, Warrington, 1792.

Thomas Robert Malthus published Principles of Population in 1798.

The population of Britain in 1701 was about 5.5 million. It was 9 million by 1810 and grew to 18 million by 1851.

In 1824 the law prohibiting emigration of workmen was repealed. Between 1830 and 1839 about 668,000 emigrated and this rose to about 1,495,000 between 1840 and 1849. See also Irish Potato Famine below.

Britain's first cholera epidemic was 1831/2. The census of 1831 showed that 28% of the population was employed in agriculture. About half the population lived in rural areas and 25% lived in towns of over 20,000.

James Phillips Kay (1804-77) (later Sir James Kay-Shuttleworth) published The Moral and Physical Conditions of the Working Classes Employed in the Cotton Manufacture in Manchester in 1832.

Birth, Marriage and Death Certificates were introduced in England and Wales on 1 July 1837. These, together with the census returns, which gave details of individuals from 1841, allowed the Registrar General to collect comprehensive statistics about mortality rates, ages at death, and causes of death.

The Report on the Health of Towns (1840)

The 1841 census showed that 45% of the population of England and Wales was under the age of 20 and less than 7% was over 60.

Edwin Chadwick (1800-1890) a poor law commissioner, wrote An Inquiry into the Sanitary Conditions of the Labouring Population of Great Britain in 1842.

Peel's Government set up the Buccleuch Commission in 1843 to verify Chadwick's Report, to investigate the health of towns and make recommendations for legislation. It endorsed Chadwick's work in the 1844 Report of the Commissioners Inquiring into the State of the Large Towns and Populous Districts.

Engels used Chadwick's work in his book Condition of the Working Class in England (1844).

The Irish Potato Famine from 1845 was caused by a fungal infection on potato plants. The population of Ireland had been 7.8 million in 1831, rose to 8.2 million by 1841 and fell to 6.6 million by 1851 as a result of starvation and migration. Many Irish moved first to England before emigration to North America.

Major cholera epidemic in 1847/8

The first Public Health Act in Britain came in 1848. It set up a General Board of Health, made corporate boroughs responsible for drainage, water supply and removal of nuisances, allowed non-corporate towns to set up local Boards of health and required them to do so if the death rate was greater than 23 per 1000 (1 in 43.5). The General Board of Health was abandoned in 1858 to be replaced by the Medical Department of the Privy Council where Dr. John Simon was the Medical Officer and initially the sole employee.

London operated independently of the Public Health Act, through its own Act of 1848 to form the Metropolitan Commissioners of Sewers. At this time London had a fragmented local government system involving 300 parishes, improvement commissions and boards of trustees working under some 250 Local Acts.

The 1851 census showed that about equal numbers of people lived in rural and urban areas.

By 1858 in Lancashire, only 400,000 of a total population of 2,500,000 were served by a public health board. Some of the Local Boards which were formed did not establish new services nor appoint Medical Officers of Health and Borough Engineers.

Florence Nightingale (1820-1910) appalled by her experiences during the Crimean War of 1854-57 became a campaigner for better hospital design and founded nursing as a profession.

The Sanitary Act of 1866 introduced an element of compulsion for local authorities to set up health boards. In 1868 the Royal Commission on Sanitary Administration was set up as a result of pressure from the statistician William Farr. The Local Government Act of 1871 and the Public Health Act of 1872 created a national network of rural and urban sanitary authorities.

The Artisans' and Labourers' Dwelling Act known as the Torrens' Housing Act established two important principles. One was that the state had the will and power to interfere with the rights of property to improve public health. The other was the duty of the landlord to keep a property in good repair.

The Public Health Act of 1875 made compulsory the appointment of a Medical Officer of Health in every sanitary district of England and Wales. This act consolidated the earlier legislation and dealt with food adulteration, sewers, drainage and epidemics.

Between 1815 and 1914 about 16.4 million emigrated from Britain. About 11 million went to the USA, 2.55 million to Canada, 2 million to Australia and New Zealand, and 850,000 to South Africa. Of these 16.4 million about 4 million were from Ireland. (See Irish Potato Famine of 1840s)

Housing of the Working Class Act was passed in 1890. The first Council housing outside London was in 1909

In 1906 the Liberal Government introduced school medical services and advice for mothers on the nutrition of infants.

The Ministry of Health was formed in 1919.

 

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