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-- hospitals
-- medical police (Germany)
-- officiers de santé (France)
-- Poor Law medical assistance (England)
-- all supported by medical profession esp. GPs

-- concern with health of populations

-- social statistics
-- cholera epidemics from 1830s
-- focus on diseases not individuals

THEORIES OF DISEASE CAUSATION AND PREVENTION

-- contagion and/or miasma

-- quarantine to prevent contagion

-- established policy at ports, resumed in 1830s in face of cholera
-- politically inexpedient in context of expanding trade and competition

-- environmental improvement to eliminate miasma

-- championed especially in Britain by Edwin Chadwick (1801-1890)
-- concerned to reduce cost of providing poor relief to the sick
-- Report on the Sanitary Condition of the Labouring Population (1842)
-- challenges the prevailing view that sickness is caused by poverty
-- emphasises insanitary living conditions instead -- sanitary movement

DEVELOPMENTS IN PUBLIC HEALTH SCIENCE

-- from 1830s, chemical theories of putrefaction

-- ptomaine theory, esp. Justus Liebig (1803-1873)
-- Max von Pettenkofer (1818-1901) and ground water theory
-- including “germs”
-- chemical techniques help to identify specific sites for environmental intervention

-- by 1880s, increasing interest in idea of germs

-- Louis Pasteur (1822-1895)
-- identifies microbe responsible for spoilt wine 1865
-- silkworm bacillus 1868
-- isolates the germ of fowl cholera 1880
-- isolates the rabies germ 1885

-- Robert Koch (1843-1910)
-- isolates the germ of anthrax 1876
-- isolates the tuberculosis bacterium 1882
-- isolates the cholera bacillus 1884

-- many more germs identified from 1890s, inc. diphtheria, typhoid, scarlet fever, syphilis

-- inc. bacteriological techniques of diagnosis

GERM THEORY AND MEDICAL POLICY

-- research on germs receives extensive state support, in UK as elsewhere

-- support for contagionist ideas is increasing again even before germs of human disease are discovered

-- trade controls make quarantine a possibility
-- e.g. cattle plague in 1860s

-- greater state controls over the lives of individuals
-- 1866 Contagious Diseases Act for control of VD
-- isolation of infectious disease cases under Local Government Act 1872
-- compulsory notification and isolation under Infectious Diseases Act 1889

-- germ theory helps to justify such measures

-- inc. bacteriological diagnosis serves to identify individual cases for isolation

-- i.e. standardised laboratory techniques suit administrative purposes
THE PROBLEMS OF HOSPITALISM

-- mortality from surgical infection growing dangerously by mid-C19

-- primarily in hospitals -- “hospitalism”

-- attributed to insanitary locations and conditions of aging hospital buildings

-- solutions proposed:

-- move hospitals out of town -- but physicians and surgeons object

-- build new hospitals in town -- pavilion plan hospitals from 1840s
-- ventilation, illumination and cleanliness
-- moral surveillance of patients

-- improve training of nurse本论文由英语论文网提供整理，提供论文代写，英语论文代写，代写论文，代写英语论文，代写留学生论文，代写英文论文，留学生论文代写相关核心关键词搜索。