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Here is the full content on Sanitary Awakening directly from Park's Textbook of Preventive and Social Medicine:

Sanitary Awakening

(Park's Textbook of Preventive and Social Medicine)
Another historic milestone in the evolution of medicine is the "great sanitary awakening" which took place in England in the mid-nineteenth century and gradually spread to other countries. It had a tremendous impact in modifying the behaviour of people and ushering in an era of public health.

Background: The Industrial Revolution

The industrial revolution of the 18th century sparked off numerous problems:
  • Creation of slums and overcrowding
  • Accumulation of filth in cities and towns
  • High sickness and death rates, especially among women and children
  • Infectious diseases like tuberculosis
  • Industrial and social problems
These factors deteriorated the health of the people to the lowest ebb. The mean age at death in London in 1842 was:
  • 44 years for the gentry and professionals
  • 22 years for the working class

Role of Edwin Chadwick

Frequent cholera epidemics compounded the misery of the people. The great cholera epidemic of 1832 led Edwin Chadwick (1800-1890), a lawyer in England, to investigate the health of the inhabitants of large towns.
  • His report: "The Sanitary Conditions of the Labouring Population in Great Britain" - a landmark in the history of public health
  • It set London and other cities on the way to improve housing and working conditions
  • Filth was recognized as man's greatest enemy
  • This began the anti-filth crusade - the "great sanitary awakening"
  • It led to the enactment of the Public Health Act of 1848 in England
  • A new thinking emerged: the State has a direct responsibility for the health of the people

Rise of Public Health (connected events)

  • Johanna Peter Frank (1745-1821) - conceived public health as good health laws enforced by the police; enunciated the principle that the State is responsible for the health of its people.
  • John Snow - studied epidemiology of cholera in London (1848-1854); established the role of polluted drinking water in the spread of cholera.
  • William Budd (1856) - concluded typhoid spread was by drinking water, not miasma and sewer gas.
  • Public Health Act of 1875 - comprehensive legislation for the control of man's physical environment.
  • Sir John Simon (1816-1904) - first Medical Officer of Health of London; more than any other, responsible for sanitary reforms; built up a system of public health in England that became the admiration of the rest of the world.
This early phase of public health (1880-1920) is often called the "disease control era".
Source: Park's Textbook of Preventive and Social Medicine, Block 1, lines 355-384
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