Changes in Health and Medicine c.1340 to the present day
General Causes of Illness and Disease in the Medieval Period
- Poor Diet: Bad harvests led to hunger, with only 25% of families able to feed themselves, resulting in widespread malnutrition.
- Living Conditions: Overcrowded houses in towns, water contaminated with waste, and straw-covered floors created breeding grounds for rats, fleas, and lice.
- Famine: A severe famine occurred in England from 1315-1317 due to torrential rain ruining planting and harvesting.
- War: Wounds from swords or axes often became gangrenous, as seen during the Wars of the Roses (1455-1485).
Problems in the Medieval Era
- Lack of understanding of the link between disease and germs.
- Filthy towns.
Medieval and Early Modern Periods (c.1300s-1700s)
Industrial Revolution
The Industrial Revolution led to the spread of factories and the growth of industrial towns and cities like Glasgow, Manchester, Birmingham, and Sheffield. Housing was built for workers near factories.
Public Health Problems in Industrial Towns
- Squalid living conditions caused outbreaks of disease.
- Tenements were overcrowded, with large families living in cramped conditions.
- Sewage contaminated drinking water, leading to outbreaks of cholera and typhoid. People did not understand that infected water spread cholera germs, instead believing that miasma (terrible smells) caused disease. This concern was evident during the Great Stink in London in 1858 when sewage made the River Thames smell.
- Dr. John Snow's Discovery: Dr. John Snow proved that cholera was a waterborne disease through his study of the Broad Street Pump in London in 1854.
Key Definitions
- Tenement: A large building divided into separate flats.
- Cholera: An acute intestinal infection causing severe diarrhea and stomach cramps, caused by contaminated water or food.
- Typhoid: A serious infectious disease that produces fever and diarrhea, caused by dirty water or food.
Industrial Period (c.1800s)
Welsh Example: Wrexham
Wrexham was a market town where livestock was brought in daily, spreading manure and urine. Animal carcasses were left to rot in the streets, and local rivers were polluted from brewing beer. There was also a lot of smoke from making nails.
Plague
Towns were breeding grounds for infection and vermin, leading to outbreaks of plague from 1348 to the Great Plague of London in 1665.
Types of Plague
- Bubonic Plague: Spread by fleas from black rats. Symptoms included swellings (buboes) in the armpits and groin, fever, headache, and boils. Death occurred within a few days.
- Pneumonic Plague: Spread by breathing or coughing germs onto one another. It attacked the lungs, causing breathing problems and coughing up blood. Death occurred quickly.
The Black Death
The Black Death entered Britain in July 1348 and spread across England, Wales, and Scotland by the end of 1349. It killed up to 40% of the UK population. In 1665, around 100,000 people died of the plague in London, nearly 25% of the population.
Welsh Example: The Black Death and Wales
The Black Death killed around 100,000 people in Wales, one-third of its population. It arrived in Wales through the coastal port of Haverfordwest in Pembrokeshire, which traded with Bristol. Carmarthen was affected soon after. Within a few months, it reached north Wales, affecting Deganwy in the northwest and the market towns of Ruthin, Denbigh, and Holywell in the northeast. Cosmeston near Penarth in the Vale of Glamorgan became a deserted medieval village.
Welsh Example: Cholera Epidemics in Wales
Outbreaks of cholera occurred in Wales in 1832, 1849, 1854, and 1866.
- 1832 Outbreak: The most affected areas were the industrial towns of Merthyr Tydfil and Swansea, and the market towns of Denbigh and Holywell.
- 1849 Outbreak: The two worst-affected towns were Cardiff and Merthyr Tydfil (with over 1,682 deaths, one of the highest death tolls in England and Wales). In the north, Holyhead, Holywell, and Flint were badly affected.
The Spread of Bacterial and Viral Diseases in the 20th Century
Increased travel, migration, and two world wars facilitated the spread of bacterial and viral diseases in the 20th century.
Case Study 1: Spanish Flu, 1918–19
A pandemic spread around the world in 1918, killing up to 40 million people. It infected 20% of the world’s population. The end of World War I helped transmit the disease as returning troops spread it to the civilian population. 7 million deaths were reported in Spain, leading to the name Spanish Flu. It could kill a person in a day, overwhelming hospitals, and killed 280,000 people in the UK.
Case Study 2: Tuberculosis
Tuberculosis is spread by coughs or sneezes and was formerly known as consumption, as sufferers gradually lost weight. It was associated with poor housing and unhealthy working conditions during the Industrial Revolution. Fresh air was thought to be the cure. By the 1950s, better sanitation and vaccination significantly reduced cases. Isolation hospitals (e.g., Penley Hospital in Wales in the 1960s) were set up to prevent the spread of the disease and provide fresh air. The rise of drug-resistant strains in the 1980s, particularly among the homeless, means that the fight against TB continues.
Case Study 3: The HIV/AIDS Threat
The first cases of AIDS were reported in the USA in 1981. The AIDS virus is spread through the blood or body fluids of infected people via sexual contact or sharing injection needles. HIV destroys the body’s immune system, and the victim dies of other infections that their body can no longer fight. By 2000, an estimated 30 million people were infected with AIDS, with Africa being the worst-affected area. By 2000, over 8 million people had died because of AIDS.
21st Century Lifestyle Diseases
New kinds of diseases have begun to affect people in the modern era.
- As people live longer, they are more prone to cancer. One in three people in the UK will be affected by it at some point in their lives.
- Lifestyle changes like increased smoking and drinking have led to a growth in obesity, diabetes, and certain kinds of cancers that did not affect people as much in earlier times.
Key Definitions
- Pandemic: A disease that spreads across a wide geographical area.
- AIDS: Acquired Immune Deficiency Syndrome.
- HIV: Human Immunodeficiency Virus.