The Great Filth: Disease, Death and the Victorian Life – Stephen Halliday (2009)

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” The greatest achievements of the Victorian era was…to accept that national and local government had a responsibility for the health, education and welfare of citizens, as well as for defense against foreign invasion and domestic justice…”

As you may already know, I am a Fangirl of Victorian social history, and so this was quite a good read. I especially enjoyed and appreciated the slightly different slant that Halliday used here – instead of most of it being about doctors, this covers a lot of the public health improvements in London (and elsewhere) were due to the diligent efforts of civil engineers and architects, as well as mathematicians and others.

pumpThis title covers both the famous and infamous of Victorian medicine – the discovery of the infected well water during an epidemic (Snow et al.), the acceptance and training of midwives, the realization of good hygiene between doctor and patient, the glacial acceptance of germ theory as opposed to the miasma theory – the topics were really interesting to me (especially when considered in the light of our recent visit to the Hunterian Museum in London ).

Some of the theory behind medicine at that time is startling to the modern eye in places. Not washing one’s hands between patients? Eeuw. There was more than one cholera outbreak during the nineteenth century, one of which occurred in 1832. As medical theory at that time did not conceive of germs being in the water (as opposed to the air)*, the London Board of Health came up with the following recommendations for its citizens to prevent cholera transmission:

* Consumption of large amounts of roast beef (assuming you could afford that)
• Poorer people should eat loads of potatoes and stale bread (the mold was thought to have healing powers)
• Avoid excess fruit and vegetables (obviously not washed and cleaned at this time)
• Finally, use brandy, laudanum, ammonia, sulphuric acid for treatment/prevention and…
• Apply mix of hot bricks and boiling water to the affected areas (Yikes)

When Victorian people became ill, there were very few options with which to treat them regardless of how old you were: “Lying-In” hospitals came to the fore where pregnant women would confine themselves to wait for their oncoming birth. (Thus, the use of the word “confinement” as linked to pregnancy. Just saying anything to do with a bodily function would repel well-bred Victorians for the most part.) In fact, if you were pregnant, you sort of hoped that you wouldn’t be put into one of the maternity hospitals as the mortality rate of both mother and child were significantly higher in them than outside.) Midwives were available, but had no formal training (apart from helping at other births, perhaps), and the doctors were initially opposed to formalizing the midwife profession fearing it would take money from their side of the equation… (The more things change…)

0ld-surgery_1Anesthesia was also quite a new technique, but it also increased the infection rate of the patients involved. Before anesthesia, surgery was very painful but very quick. After using anesthesia, the surgeons could take more time and care to be accurate while wielding a scalpel but the longer exposure of open wounds to the polluted air (and environment) also meant that death rates would increase for a while. Joseph Lister was the guy who helped to introduce the necessary steps in anesthesia and hygiene that would bring this death rate down. (BTW, Queen Victoria was one of the first women in the UK to ask for anesthesia during the births of some of her children. After that, there was a big trend for it, of course, when patients could afford it.)

Joseph Bazelgette, a civil engineer, was instrumental in improving the drainage in London and its surrounding areas, and in fact, when you walk along some of the embankments next to the Thames, you are walking on top of the great Victorian drains that he designed and that made such a big difference to the public’s health at that time.

“…the principal role in preventive medicine was taken, half knowingly by civil engineers…”

So, as mentioned briefly, there was a ton of good info in this book. However… (Now, I realize that this could sound nit-picky, but it still affected my reading experience nevertheless.) Halliday used different references whenever he referred to a male or female person who had played a role in this history. Men were first mentioned with first name/last name format, and then referred after that by last name only.
Women were first mentioned first name/last name format, but then referred to after that by their first names only. (So – Louis Pasteur/Pasteur or Florence Nightingale/Florence.) This irked me quite a lot as I thought it was infantilizing the women and their achievements and I was not happy with that. At first, I thought it was an editing error, but as the read continued, it was clear that it was an editing decision. My, my, my. Published in 2009 so not that old a book, so I am curious why the book was formatted in that manner…

*The word Malaria reflects this miasma theory: “Mal” is “bad” and “aria” is “air”… Fascinating when you think about it (at least to me).

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