Public Health and Technology during the 19th Century

In 1750 only 15% of the population lived in towns, however by the time Phillip Reis invented the telephone in 1860 nearly 80% lived in the urban areas. At the turn of the century the ratio of women and children to men working in the factories of Europe and the newly formed United States was four to one. They labored long hours for small wages in the gas lit sweatshops and factories. Life spans were short. If you owned the manufacturing business your life span was anywhere from 35 to 45 years of age. Developments in the steam engine had allowed the factory, which had been powered by a water wheel near a stream, or a river to move into the city. Before the revolutions of 1948, child labor laws, the 8-hour day, or public education for the masses there were the workhouses in the filthy urban centers of most major countries. Indecent housing, flooded basements, overcrowding, overflowing cesspools, contaminated water supplies, poverty, and hunger allowed diseases like typhus, typhoid fever, diphtheria, rickets, tuberculosis and scarlet fever to thrive. Although anatomy had been intensely studied and well documented Medicine was still breaking from the dark ages. Great strides were being made in every area from bedside philosophy in the hospitals of France to the way the English began to educate its interns. These were all very encouraging steps but it would be another 70 years before medicine would begin to contain and manage major public health issues.

Cholera delivered by modern transportation

Unfortunately the great strides in modern transportation accelerated the spread of cholera from India in 1816 to the ports of the Philippines, China, Japan, Persian Gulf then north toward the Ottoman and Russian empires killing thousands by 1826. The second Cholera out break swept London in1832.7000 people died a horrible death in England. The symptoms of cholera are Internal disturbances, nausea and dizziness which led to violent vomiting and diarrhea, with stools turning gray liquid (sometimes described as rice water) until nothing emerged but rice water and fragments of intestinal membrane. Extreme muscular cramps followed, with an insatiable desire for water, followed by a sinking stage- the pulse dropped and lethargy set in- Dehydrated and nearing death the patient displayed the classic cholera physiognomy: puckered blue lips in a cadaverous face. This was only the beginning. 3 more major cholera epidemics would run wild taking the lives of thousands more before the end of the century.

Technology tools for Public Health

On rare occasions technology provided tools to improve public health.
R. T. H. Laennec invents the stethoscope in France 1816. This new technology would help in the fight against the single worst disease of the urban landscape, tuberculosis. The disease was characterized by fever, night sweats and coughing up blood. It was called "the consumption" because the victims were almost literally consumed by it. If you contracted TB your chances of survival were about %60. This sickness would take both of Alexander Graham Bells brothers from him in the 1860’s. Laennec published his paper on the device " traite d auscultation mediate " in 1819. It is one of the few instances where technology actually helped to make life better. Another great stride in which technology contributed to better public health was the further perfection of the Microscope by the Germans. The meticulous work in Optics by Carl Zeis. Coupled with new approaches in the study of human physiology by German researchers and groundbreaking work by Schwann, Schleiden, and Virchow allowed for the battle of disease at the cellular level. On a greater scale the Doctor, now the newly created "Public Health Officer" and the Civil Engineer worked together to improve the deplorable sanitary conditions in the major cities. These were major engineering and construction efforts in the urban areas. They required extensive financing and took years to complete.

Edison, Bell, and Infant mortality

In 1847 Thomas A. Edison is born on February 11th in Ohio, USA, Alexander Graham Bell is Born on March 3rd in Edinburgh Scotland. Born just three weeks apart they were both triumphant over the dangerously high Infant mortality rates of their time. A harsh world took the lives of nearly 25% of all infants born during this period. Infant mortality rate is the death of a child before their first birthday; this is an annual rate of deaths measured in one thousand childbirths. The infant mortality rates in the early to mid 19th century were high. The babies raised in ideal conditions, clean environment, regularly breast fed, and well cared for could expect death rates of 80 to 100 per thousand. The inner city rates were dramatically higher, 300 deaths per thousand on average mainly due to the poverty, dreadful housing situations, and unhealthy urban sanitary conditions. The development of obstetrics, which encompasses all aspects of pregnancy, birth and its result, evolved into the rise of gynecology. This moved the care of the Mother and child from the home and the midwife to the hospital and the doctor. Puerperal fever or (metria, puerperal septicaemia or puerperal sepsis) is an infection of the uterus usually contracted during or right after the delivery of the child. This was the main cause of death in childbirth during the 19th century. Although the disease would almost always show up in the autopsy, the fact that it was contagious became a heated debate in the medical community. Finally through the work of Holmes (1809-94; Boston, 1843) and Semmelweis (1818-65;Vienna, 1858) it was proved that the Doctors and Midwives carried the infection and that by simply washing their hands death rates would drop dramatically.

Poor Public Health Sparks Revolution

It was this poor state of public health, which sparked "The Year of Revolutions" in 1848. Ireland's potato crops fail causing the deaths of 1 million with another 1 million leaving the country in "coffin ships" to try and escape the great hunger. The Irish Famine started in 45 and peeked in the winter of 46-47 and continued until 1851. The misery of the Irish people was not far behind that of the rest of the bourgeoisie, also known as the middle class, throughout Europe. It was this discontent across Europe, which sparked the revolutions of 1848. Governments of Frankfurt, Poland, France, Italy, Prague, Hungary, and Vienna were blamed for the harsh living conditions, which affected most of the population. This forced the issues of basic human rights to the foreground, which started socio-economic changes throughout Europe. In this year of revolutions Carl Marx writes the "Communist Manifesto" and gains notoriety. The year before Marx's text the original German manifesto which included parts of Engels draft, "Principles of Communism" was published anonymously in London toting the slogan "Workers of all countries unite!"

Child labor, malnutrition and rickets

As a young boy Faraday grew up in real poverty. He was fortunate to have secured the job as a bookbinder apprentice. Many children in England were not as lucky. The Factory act of 1833 proclaimed that children could not work until the age of 9, and that the children who were working between the ages of 9 to13, could not put in more then a 48-hour week. This was the first of several Child labor laws to go on the books in England. The state of the children's health working in these death mills was nothing less than horrible. Suffering from malnutrition many contracted rickets (the softening of the bones) leaving them with bending leg bones. Modern technology was delivering goods at a high price. Fortunately this did not go unnoticed by groups of Humanitarians like Engles, an English factory owner himself, who pushed on forcing these social issues to the foreground, which resulted in the Mines act of 1842; Ten Hours act of 1847; 1867 Gangs act; and in Prussian the decree of 1839. The 1876 Education act made it illegal to employ children under the age of 10 in agricultural work. However even with these laws in place industry money insured the miss use of children continued into the 1920’s. Children between the ages of 13 to 19 were still enslaved and the younger child between the age of 9-13 working "Half time" work half the day in the factory leaving the students to tired to perform in school that afternoon. This is stressed in many reports on education to parliamentary reports.

By the turn of the century Public Health improved dramatically.

Mass education along with sanitary conditions for the general public and the advances in obstetrics all led to the decline of Infant mortality rates at the end of the 19th century. By 1884 the Cholera organism was identified in water via the microscope and could now be contained by public health officials. The scientific revolution in cellular biology excelled in the second half of the nineteenth century unlocking doors and answering many questions in the fight against disease. Legislation regarding Public Health issues finally came from many governments after the revolutions of 1848. These Laws were passed and promoted not because of a real genuine concern for peoples health, but more out fear of what the masses might due if something was not done to protect them from epidemic disease. When we look back on the century the over all health of the average person improved despite modern technology not because of it.