Public Health in Early Modern Britain

The Early Modern era was a time of great change in many areas of society, politics, and economics. Medicine was not an exception to this and was influenced by several key individuals and movements like the Renaissance and the Enlightenment.

So, what was public health like in the Early Modern era, and how did it change throughout the period? Let's find out!

History of Public Health in Early Modern Britain

Here is a brief timeline showing the most important events for public health in Early Modern Britain.

The Condition of Public Health in Early Modern Britain

The health of the early modern environment had changed little from the medieval era. Although some monarchs had introduced laws to clean up the towns and cities of early modern Britain, they had very limited success. Overall, the environment remained largely unhygienic.

Public Health Infrastructure

The Great Plague of London in 1665 highlighted the insufficiency of England's public health system. Towns and cities had not built proper systems for waste disposal, like sewers, and clean water was non-existent for the common man. Equally, there was little in the way of community health support.

The 16^th century Reformation had removed the Catholic Church, which had previously been the source of medical care for many people. Hospitals still were not places where people were treated for illnesses; they acted more as guest houses.

Medical Practices

In the early modern era, the same types of medical practitioners existed:

• Physicians: Usually university-educated men, physicians were employed by those who could afford them. They observed and diagnosed but did not make remedies or perform surgery.
• Apothecaries: Mixed remedies, usually according to a physician's instruction. Their remedies would be used by all types of people. They sold them out of their shops.
• Barber-Surgeons: Hairdressers performed minor surgeries due to their experience with sharp blades. Considered the lowest form of medical practitioner, they performed routine procedures like bleeding and teeth-pulling and more serious things like removing gallbladder stones.

Fig. 1 - An engraving of an early modern apothecary

Causes of Illness in Early Modern Britain

Beliefs about what caused illnesses did not change much in the early modern era.

The Theory of the Four Humours was popular at the beginning of this period, but belief amongst medical professionals quickly declined towards the 18^th century. However, it was still a popular explanation amongst the common people and influenced home remedies.

Miasma (the theory that bad air causes illness) remained popular for explaining diseases, particularly when an epidemic struck. Without the knowledge of germs, miasma remained the best explanation.

Common Problems of Public Health in Early Modern Britain

Early Modern Britain had many public health issues throughout the period.

Epidemic Diseases

Below is a table of common diseases present in the Early Modern period.

The Great Plague, 1665

In 1665, a plague epidemic broke out in London, killing nearly a quarter of London's population. There had been several other plague outbreaks before, notably at the end of the 1500s. Nevertheless, it was a disaster and highlighted the poor state of public health.

The Gin Craze

At the beginning of the 18^th century, two very important things happened:

• Food prices dropped, and incomes rose.
• Gin became easier to produce.

However, the outcome was an epidemic of drunkenness amongst London's citizens. It became a huge social issue, being cited as an explanation for the rise in crime and laziness, as well as poor health. The government eventually had to pass legislation to kill the gin trade.

Fig. 2 - 'Gin Lane' by William Hogarth. This was supposed to be a reflection of the impact of the Gin Craze on London society

Quackery

In the early modern era, there was a phenomenon of people who would set themselves up as street sellers and try to sell their own concoctions as bona fide medicines that could cure any range of illnesses. The medicines they promoted had no health benefits, but they encouraged people to buy them so they would make money. This practice was known as 'quackery'.

The term 'quack' became an insult to medical practitioners in the later early modern period.

Improvement of Public Health in Early Modern Britain

Public health in Early Modern Britain changed considerably over the centuries - in this section, we will look at key individuals who caused these changes and what they meant for British society.

Key Figures

Here, we will look at three of the key figures in the improvement of public health in Early Modern Britain.

Vesalius

Andreas Vesalius was a Belgian physician who made huge contributions to the field of anatomy. He became a professor of medicine at Padua university at the age of just 22, and he insisted that his students perform medical dissections - something that had previously been banned by the Church.

His 1543 work, On the Fabric of the Human Body, gave new drawings of the human anatomy and actually proved some of Galen's theories wrong. This was quite important, as Galen's theories had been trusted for the past 1,500 years.

Paré

Ambroise Paré was a French military surgeon who came up with many new ideas about surgery. He suggested new forms of antiseptics and introduced ligatures to tie off blood vessels in order to stop blood loss. Whilst surgery still remained a very dangerous procedure, Paré's work helped form the foundations for later surgical advancements.

Harvey

William Harvey was an English physician who is known for discovering the principle of blood circulation. Previously, doctors had believed that blood was made in the liver. Harvey proved that blood circulated around the body and that the heart acted as a pump.

Sydenham

Known as the 'English Hippocrates', Thomas Sydenham was a hugely influential figure in early modern medicine. He followed Hippocrates' idea of observing the patient, noting the symptoms, and then providing a cure for each symptom individually instead of trying to treat the disease as a whole.

From this, he believed that instead of an imbalance of humours, people could suffer from the same diseases and that some diseases were similar.

Fig. 3 - 'The anatomy lesson of Doctor Nicolaes Tulp' by Rembrandt

The Impact of the Renaissance

The Renaissance was a period of 'rebirth' in Europe, with a championing of new ideas about art, music, culture, and science. Medicine was included in this, and medical knowledge began to pull away from the old traditions of the medieval era.

The figures mentioned above all lived and worked during the Renaissance and were key to developing new ideas about medicine and the body.

The invention of the printing press in the 1440s allowed medical knowledge to be more accessible to those who wanted to learn. Equally, it allowed new ideas to flourish as the production of texts was no longer solely in control of the Church.

In the 18^th century, the Enlightenment spread to Britain - it was an intellectual movement that focused on the use of reason to make advances in politics, economics, and science.

Public health and medicine were affected by the Enlightenment, below is an overview of some notable changes.

• Medicine became more professionalised as people who wanted to be doctors had to go through more rigorous training.

• Hospitals became places where sick people were treated, and more hospitals were built thanks to the charity of wealthy people.

• There were new inventions of surgical tools and surgical procedures.

• Operating theatres opened, and dissections became less taboo, allowing for more detailed studies of human anatomy.

Fig. 4 - A drawing of Guy's Hospital, Southwark, London

Infrastructure

The way town and cities were laid out, as well as housing conditions, had a significant impact on public health.

The Great Fire of London

Peculiarly, the Great Fire of London in 1666 actually helped improve public health! After the fire, the city had to be rebuilt. To prevent another fire from ever spreading that quickly through the city again, all the houses were built further and apart, and the streets were made wider.

This meant that people were living further apart and that there was more space; therefore, diseases could not spread so quickly!

New Houses

When new houses began to be built in the 1700s, they were built out of brick rather than wood. This was beneficial to public health as brick houses were more insulated and warmer, thereby keeping people healthier. Equally, materials like wattle and daub, which attracted rats and lice, were no longer used, which made the houses cleaner.