It caused also many deaths in the 20th century, over 300–500 million. However, the circumstances that propelled the development of public health as a discipline are more complex with many contributing factors. It killed people of all social classes, as lice were endemic and inescapable, but it hit particularly hard in the lower or "unwashed" social strata. The spread of European empires and the development of new forms of transport such as the steam engine made it easier for both humans and rats to spread the disease along existing trade routes. ", Image of small boy with polio standing with crutches. The investigation continued. One theme was that the reduction of mortality and improvements in health had an economic value to society. Louis Pasteur was a French biologist and chemist who made enormous contributions to germ theory, to prevention of food spoilage, and to the control of disease. Cholera continues to be a problem throughout the world today (see Cholera in Haiti). [52] Scarlet fever spreads through respiratory droplets and children between the ages of 5 to 15 years were most affected by scarlet fever. He decided to require all attendants to wash their hands in chlorinated lime water before attending to a birth, and the rate of infection plummeted. The Philippines were infected in 1858 and Korea in 1859. [Note: Many of the facts and images below were gleaned from the US National Library of Medicine's web pages on The History of the Public Health Service.]. 20 to 60% of all the people that were infected died and 80% of all the children with the infection also died. Scurvy is due to a deficiency in vitamin C that results in weak connective tissue and abnormally fragile capillaries that rupture easily, causing bleeding, anemia, edema, jaundice, heart failure, and death. [1] So as those in authority scrambled to make leaps and bounds in science and track down what may be the cause of these epidemics, entire communities would be lost to the grips of terrible ailments. [13] Snow believed that germ-contaminated water was the source of cholera, rather than particles in the air (referred to as "miasmata"). Throughout Spain, cholera caused more than 236,000 deaths in 1854–55. [1][2], During these many outbreaks, members of the medical professional rapidly began trying different cures to treat their patients. The Greeks believed that the god Jupiter was angry about man accepting the gift of fire. The video is a segment of a PBS video on public health. [3] But, because of the chaos of cures and treatments you could find being tried out on the streets, his cure was sub sequentially lost to the chaos of the times. He advocated for medical reforms and was a strong proponent of the idea that doctors and nurses could carry puerperal fever from patient to patient. The illustration on the left shows a "plague doctor," who is covered from head to toe, including a hood, a mask, gloves, and a beak-like sack on his nose. However, the inability to identify the cause and the inability to identify effective control measures was not due to a lack of sophisticated technology. Dobyns (1966) suggests the low point of 490,000 was reached in the 1930s, although it can be assumed that the initial waves of epidemics during the 1600s and 1700s were responsible for most of the depopulation. Much of the work of the early plague fighters and sanitarians is now carried out by the scientists at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. [23] In 1849, outbreak occurred again in Paris, and in London, killing 14,137, over twice as many as the 1832 outbreak. The 1892 outbreak in Hamburg killed 8,600 people. Chadwick's report provided momentum for the establishment of a number of societies and pressure groups consisting of politicians, civil servants, & social reformers lobbied parliament. An excess of the humour blood, for example, became the rationale for bloodletting, a practice that was followed for centuries (without any evidence of its efficacy). Pasteur developed vaccines against anthrax in sheep and cholera in chickens. It is most prevalent in tropical-like climates, but the United States was not exempted from the fever. [56] Cases of scarlet fever were also seen in Boston during a period of decreasing severity after 1885. People also began to rely heavily on one or two crops, so their diets were often lacking in protein, minerals, and vitamins. It is also noteworthy that Lind was able to correctly identify a means of preventing scurvy even though he misunderstood the cause. Urban epidemics continued in the United States until 1905, with the last outbreak affecting New Orleans. Greek physicians prescribed changes in diet or lifestyle and sometimes concocted drugs or performed surgery. Legislative Assembly of VI asks England for funds to extinguish aboriginal title; denied 1861. Some consumers were supplied by the Lambeth Company, while others were supplied by Southwark & Vauxhall. In 1846, cholera struck Mecca, killing over 15,000. It is interesting to note that many of the proponents of the "Sanitary Idea," including Edwin Chadwick (shown on the right), were "miasmatists" who clung to the belief that disease was caused by breathing foul vapors. The maps to the right illustrate the concentration of population into the cities of England that occurred over 200 years beginning in 1700 as shown in these maps of population density in 1701 and 1911. In the 1800s there were large epidemics of cholera in Europe and America that killed thousands of people. The rats, therefore, serve as a natural reservoir for the disease, and fleas are the vectors. Medical officers, called surgeons, were required to pass entrance examinations and wear uniforms. This particular segment focuses on events at the dawn of the 20th century when bubonic plague threatened San Francisco. Typhus appeared again in the late 1830s, and between 1846 and 1849 during the Great Irish Famine. These ideas provided important underpinnings for public health. Though Filippo Pacini had isolated Vibrio cholerae as the causative agent for cholera that year, it would be many years before miasma theory would fall out of favor. Matthew R. Smallman-Raynor PhD and Andrew D. Cliff DSc, Marr, J. S., & Cathey, J. T. (n.d.). [56] In the early 19th century the scarlet fever impact drastically changed and lethal epidemics started to arise in the United States. This relationship has persisted for centuries, and it is a powerful predictor of health. Lind concluded that his hypothesis was correct, reported his findings, and recommended that sailors receive a ration of lime or lemon juice. He received his M.D. Epidemic typhus is caused by the bacteria Rickettsia Prowazekii; it comes from lice. The 1802 Saint-Domingue yellow fever epidemic and the Louisiana Purchase. They lived and traveled in small groups and hunted and foraged for food. The Bubonic Plague (1347-1700s) [56] The United States had a notable outbreak of scarlet fever in Minnesota in 1847[53] and Augusta, Georgia had a lethal epidemic in 1832–1833. He began as an apprentice in a dry goods store where magnifying glasses were used to inspect the quality of cloth. The shift from the hunter-gather mode of living to an agricultural model provided a more secure supply of food and enabled expansion of the population. In 1843 he presented a paper entitled "The Contagiousness Of Puerperal Fever" at the Boston Society for Medical Improvement (see engraving below). Economic growth and inventions spawned factories and textile mills in US cities. While most would include mental health as an important aspect of public health today, Winslow's definition is still relevant. Others thought it was spread by person to person contact, or perhaps by too much sun exposure, or by intentional poisoning. Working conditions were difficult and exposed employees to many risks and dangers, including cramped work areas with poor ventilation, trauma from machinery, toxic exposures to heavy metals, dust, and solvents. "Medical discoveries and public health campaigns have almost eliminated deaths from the common diseases of childhood such as measles, diphtheria, scarlet fever, and whooping cough. He is most often credited with solving an outbreak of cholera that occurred in London in 1854 (the outbreak is described below), but his studies of cholera were much more extensive than that. In 1699 Francesco Redi boiled broth and sealed it; no growth occurred, suggesting that Fracastoro was correct. His study proved contaminated water was the main agent spreading cholera, although he did not identify the contaminant. Semmelweis began to wonder whether contagion could be carried on the hands and transferred to the women during childbirth. [1] Medical institutions were also transitioning to new hospital styles to try to prevent the spread of disease and stop over crowding with the mixing of the poor and the sick which had been a common practice. The third pandemic of plague originated in this area after a rapid influx of Han Chinese to exploit the demand for minerals, primarily copper, in the latter half of the 19th century. Cholera is transmitted primarily by drinking water or eating food[16] that has been contaminated by the cholera bacterium. doi:10.1097/PHH.0b013e318252eea8, spread of European empires and the development of new forms of transport, "The history of vaccines and immunization: familiar patterns, new challenges", "Osservazioni microscopiche e deduzioni patologiche sul cholera asiatico", "How Epidemics Helped Shape the Modern Metropolis", "The 1832 Cholera Epidemic in New York State: 19th Century Responses to Cholerae Vibrio (part 2)", Vibrio cholerae in recreational beach waters and tributaries of Southern California, http://coloquioscanariasamerica.casadecolon.com/index.php/CHCA/article/viewFile/9072/8523, Kaoru Sugihara, Peter Robb, Haruka Yanagisawa, Local Agrarian Societies in Colonial India: Japanese Perspectives, Eastern European Plagues and Epidemics 1300–1918, Vibrio Cholerae and Cholera – The History and Global Impact, "M993X.5.1529.1 | The government inspector's office", "Gibraltar's 1804 Yellow Fever Scourge: The Search for Scapegoats", Infectious Diseases: Plague Through History, "The Dynamics of Scarlet Fever Epidemics in England and Wales in the 19th Century", https://en.wikipedia.org/w/index.php?title=Diseases_and_epidemics_of_the_19th_century&oldid=1007370400, CS1 maint: bot: original URL status unknown, Articles with unsourced statements from July 2020, Creative Commons Attribution-ShareAlike License, This page was last edited on 17 February 2021, at 19:57. [41] In the United States, epidemics occurred in Baltimore, Memphis and Washington DC between 1865 and 1873, and during the US Civil War. It hit Russia hardest, with over one million deaths. The most popular explanation was that it was caused by "miasmas," invisible vapors that emanated from swamps or cesspools and floated around in the air, where they could be inhaled. In 1859, an outbreak in Bengal contributed to transmission of the disease by travelers and troops to Iran, Iraq, Arabia and Russia. One theme was that the reduction of mortality and improvements in health had an economic value to society. [1] This included the first uses of chloroform and nitrous dioxides as anesthesia, important discoveries in regards of pathology and the perfection of the autopsy, and advances in our understanding of the human body. [1] They had yet to figure out what actually causes disease. [9] During the first cholera epidemic, Edwin Chadwick made an inquiry into sanitation and used quantitative data to link poor living conditions and disease and low life expectancy. The Ansei outbreak of 1858–60, for example, is believed to have killed between 100,000 and 200,000 people in Tokyo alone. Among others, these included: Through their efforts landmark legislation was passed including: These efforts had an enormous impact. Girolamo Fracastoro (shown below) was an Italian physician, poet, astronomer, and geologist, who wrote about 'disease seeds' carried by wind or direct contact. He discovered that some microorganisms require oxygen (aerobic organisms), while others reproduce in the absence of oxygen (anaerobic). Pasteur pioneered the idea of artificially generating weakened microorganisms as vaccines. Queensland tick typhus is caused by the Rickettsia Australis bacteria, from ticks. [53], In Europe, scarlet fever was considered benign for two centuries, but fatal epidemics were seen in the 1700s. [36] In 1867, 113,000 lost their lives to cholera in Italy. [53] There were multiple outbreaks in different locations of Chile, including Copaipo in 1875 and Caldera in 1876. It was also noted that there was an extremely low incidence of cholera at a nearby work house and also at the Lion Brewery, and both of these businesses had their own water supply. [37] and 80,000 in Algeria.[34]. Twenty years later the Secretary of the Board of Health of Massachusetts based his plans for public health on Shattuck's recommendations. [51] There was a reduction in child mortality from scarlet fever when you compare the decades, 1851–60 and 1891–1900. Deaths peak on September 2, when there were about 130 deaths, and the cholera death rate gradually declines to near zero over the next three weeks. [53], Similarly to Europe, America considered scarlet fever to be benign for two centuries. There were certainly theories of how the plague spread and these led to preventive strategies, but none of the theories or preventive strategies or treatments were ever tested by collecting observations in groups of people. [56] In 1870, the US census showed a decrease in scarlet fever mortality in children below the age of one. The engraving above on the right above shows a woman emptying her bedpan into the street of a medieval village. This type of map, which marks the location of disease cases, is now referred to as a "spot map.". The symptoms of the fever are: Headaches, back and muscle pain, chills and vomiting, bleeding in the eyes and mouth, and vomit containing blood. (Quote from Professor Charles D. Meigs). [9][10] Sanitation prior to this was very poor and sometimes attempts to get better sanitation often exacerbated the diseases, especially during the cholera epidemics because their understanding of diseases relied on the miasma (bad air) theory. 1700s to the Present ... Epidemics appear on the Pacific Northwest coast 1780. The cause of the plague was not known, but there were many theories. [1][2] With the increasing rise in urban population, disease and epidemic crisis became much more prevalent and was seen as a consequence of urban living. [56] In the mid 1800s, more specific epidemiological information was emerging and incidence in infants were found to be low. With regard to puerperal fever, Meigs's position was: "I prefer to attribute them to accident, or Providence, of which I can form a conception, rather than to a contagion of which I cannot form any clear idea, at least as to this particular malady." In Massachusetts, colonists there saw smallpox … The video below is a segment from a PBS documentary on public health. Smallpox vaccine was available in Europe, the United States, and the Spanish Colonies during the last part of the century. The story is long and complicated, but Zeus crammed all the diseases, sorrows, vices, and crimes that afflict humanity into a box and gave it to Epimetheus, the husband of Pandora. In fact, it is caused by a small bacterium (a rickettsia). [53] The United Kingdom saw cases in Canterbury from 1839 to 1865 with 305 deaths, Bristol in 1870 with 106 deaths and in 1875, and Manchester in 1886 with six cases. [15][26][27][28] In 1851, a ship coming from Cuba carried the disease to Gran Canaria,[29] killing up to 6,000 people. He tested this hypothesis systematically by making comparisons between groups of people. B. Hill, 'Smoking and carcinoma of the lung: preliminary report', BMJ, 1950, 2.746). To Bentham the welfare of both the wealthy and the poor could be achieved most efficiently with good governmen. Snow learned from municipal records that two private companies supplied piped in water to the areas that were primarily affected by cholera. The US also underwent a rapid transition from a rural, agricultural society to one that was intensely urban and industrial. In the fifth cholera pandemic (1881–1896), according to Dr A. J. However, increasing numbers of businesses and homes had water piped from the Thames River by private companies. Using his inventions, he was the first to see bacteria (1674), yeast, protozoa, sperm cells, and red blood cells. Public health is the disaster that didn't happen. 1849 The Massachusetts legislature appointed a Sanitary Commission 'to prepare and report to the next General Court a plan for a sanitary survey of the State', with Shattuck as Chief Commissioner and author of its report. Holmes was opposed by a number of members of the society, including Dr. Charles Meigs, a prominent obstetrician. There were many subsequent waves of plague that swept through Europe until the late 1700s. England secured a bride, plus the islands of Bombay and the town of Tangier (in Morocco), trading privileges in Brazil and the East Indies, and 2 million Portuguese crowns. [22] Japan suffered at least seven major outbreaks of cholera between 1858 and 1902. He believed toxins within the body were normally released through pores in the skin and that scurvy was the result of damp sea air causing pores to close, thus trapping toxins within the body. The map below shows the spread of plague over a three year period from Asia across the Black Sea into the Mediterranean and then through Italy, France, England, Northern Europe, and into Scandanavia. (A)New England populations tended to be larger and more gender balanced. "The working environment and its effect on worker's health became a major area of study for the Public Health Service starting in 1910. Yet another factor was the recognition that poor health was a burden that fell disproportionately on the poor. A second cholera pandemic began in 1829, reached Russia, causing the Cholera Riots. [47], The third plague pandemic was a major bubonic plague pandemic that began in Yunnan, China in 1855. At least 30,000 of the 90,000 Mecca pilgrims died from the disease. In the engraving below Broussais can be seen instructing a nursing sister to continue to apply leeches to his patient (who is already quite pale from loss of blood). Further expansion of the population and mass migration caused explosive growth of cities. Unfortunately, 50 years passed before the British navy acted on Lind's recommendations and began to provide lime juice to sailors at sea. As the infection spread, the victim would experience headache, high fever, delirium, and finally death in about 60% of cases. The epidemic quickly subsided. The graph below shows the correlation between poverty and mortality rates among different districts (arrondissements) in Paris found by Villerme. [53] The disease spread from Valparaiso to Santiago from 1831 to 1832 and claimed 7,000 lives. ", Epidemics of contagious diseases, such as small pox, yellow fever, and cholera, had devastating effects throughout the 19th century. Another large epidemic occurred in 1848 and lasted through 1849.
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