From Cradle to Grave: Health, Medicine and Lifecycle in Modern Britain (HI278)
Lecture 5: Childhood, Illness and Disease
Infection Disease Description
 Epidemic - prevalent in waves, short-term; attack populations
indiscriminately.
 Endemic – diseases that are regularly found within a general population.
 Pandemic – global outbreak of disease in a limited time period.
Measurement of Disease Mortality
 Bills of mortality – 17th century onwards
 1836 Birth and Deaths notification act
Historiography - Falling Disease Related Mortality in 20th Century
 Pre 1970 – Medical progress
 McKeown thesis – Better nutrition and sanitation
 Simon Szeter & Amy Hardy – McKeown over emphasised impact of nutrition. Other factors need to be
considered – public health intervention, changing social and cultural traditions and standards of nursing
care.
Smallpox – Inoculation and vaccination
 Major killer disease in 18th and 19th centuries. Especially dangerous to children. Epidemic and endemic.
 Inoculation – introduced in 1720 from Turkey by Lady Mary Wortley Montague.
 Vaccination – invented in 1790s by Edward Jenner. Safer and more reliable that inoculation.
 1840 – Vaccination Act – directed poor law medical officers to vaccinate ‘all persons resident’.
 1853 – Legislation made vaccination compulsory for infants under 3 months.
 Some backlash against state vaccination - 1866 Anti-Vaccination League.
 World Health Organisation declared the disease eradicated in 1977.
Tuberculosis - Sanatoria and nutrition
 Major killer in the 19th century - especially in London and Industrial towns.
 1839 – 17.6% of all deaths in England. Early 20th century – 75,000 deaths a year
 TB service and sanatoria established. Streptomycin discovered in 1953.
 Already in decline – link between malnourishment and TB (supports McKeown thesis)
Cholera – Public health and sanitary reform
 Overall impact on population rates lower than other diseases but had a devastating short term impact.
 Reached Europe from India in 1826. Major Outbreaks in Britain: 1831-2, 1848-49, 1853-4 and 1856-66.
 Death Rates in 1832: Edinburgh and Glasgow – 3,166; Leeds – 700; York – 200; Liverpool – 1, 500;
Manchester and Salford – 900.
 Widely understood that it was caused by bad ‘miasmas’ related to unsanitary conditions, poor water.
 Moves to combat the problem 1830-60: 1831 – Central Board of Health; 1842 – Chadwick Report; Public
Health Act 1848.
 1855 – John Snow discovered the link between cholera and contaminated water supplies.
 Legislation: 1848 Public Health Act; A855, 1860, 1863 ‘Nuisance’ Removal Acts; 1866 Sanitary Act; 1872
Public Health Act; 1875 Public Health Act; 1899 Infectious Diseases Notification Act
Further Material - Please see the lecture slides for further discussion of: Measles, Polio, Infectious Diseases
Notification Act, Isolation Hospitals, Household Advice and Nursing. Also see the slides for visual source
material relating to vaccination.
K.Woods 2.11.2015