Weekend - Victorian Health: Dickensian Doctors Clean Up Their Act; as the Tide of the Industrial Revolution Swept across Britain, Things Were Far from Rosy. Cramped, Dirty Cities Allowed Diseases to Ravage the Population. but Modern Medicine and Key Hygiene Advances Were Beginning to Save Lives, as Mel Hunter Explains

Article excerpt

Byline: Mel Hunter

'Dirt besmeared walls and decaying foundations; every repulsive lineament of poverty, every loathsome indication of filth, rot and garbage - all these ornament the banks of Folly Ditch,' wrote Charles Dickens in Oliver Twist.

Dickensian Britain was a bleak world where disease and deprivation were the rule rather than the exception.

But though industrialisation brought with it huge social problems, advances in health care in Victorian times were also inextricably linked to the huge changes sweeping through society.

The most significant of these upheavals was of course the Industrial Revolution which created new health challenges as well as new technology to drive forward the work of physicians.

Cities - with Birmingham at the forefront - developed at such a speed that public health became a major preoccupation. Unhealthy and overcrowded dwellings overflowed to create slum areas which were a breeding ground for germs.

But the pace of change was such that legislation lagged way behind and it was only with the passing of the Public Health Act in 1848 that progress began to be made. Driven by a determination to better the lot of the working classes in industrial cities, Sir Edwin Chadwick prepared a report which was received by Parliament with 'astonishment, dismay, horror and even incredulity'.

The 1848 act laid down for the first time the principle that a state was responsible for the health of its people - a principle which continues to be one of the cornerstones of health care today.

Chadwick introduced glazed earthenware pipes for sewage which reduced the possibility of drinking water being contaminated with deadly bacteria. This and other preventative measures aimed at improving the environment formed the main thrust of health advances during the latter half of the 19th century.

One of the great sanitation inventions was unveiled in 1851 at the Great Exhibition. Public toilets known as 'monkey closets' were installed in the Crystal Palace by George Jennings, who also coined the phrase 'spend a penny' because that was how much you paid for the privilege.

The Victorian era also saw the work of the physician advance. Huge leaps occurred in scientific understanding and changes were made in day-to-day medical practise - changes which today we take for granted.

The changes came quickly. Until the Victorian era advances in medicine and anatomical understanding had been sporadic. The rush of knowledge in the 19th century meant individual physicians had trouble keeping up and so specialisation started to take hold.

The main scientific and medical changes which occurred were in the fields of anaesthesia, antisepsis and asepsis, microbiology and radiography - all areas which today form the basic foundations of modern health care.

Although chloroform had been discovered in 1831, anaesthesia did not gain general acceptance until Queen Victoria herself requested an anaesthetic for the birth of her seventh child, Prince Leopold. With Royal assent anaesthesia became at once acceptable and fashionable and was soon put to use in all hospitals.

It was the work of one man, Louis Pasteur, which turned medical theory on its head. Pasteur advanced his germ theory with such conviction, and backed by so many experiments, that the medical community was forced to concede his ideas were correct.

Pasteur, who went on to develop pasteurisation for destroying micro-organisms in liquids, as well as inoculations against anthrax and rabies, put forward the idea that if diseases were caused by germs, disease prevention rested on stopping germs from entering the body. It was this theory which was the basis for further work on the importance of physicians working in antiseptic conditions.

Creating antiseptic - and later aseptic conditions in operating theatres - was to have a profound effect on mortality rates. …