1. Living conditions in
Middle Ages:
For peasants in the countryside:
Peasants (majority) heavily
dependent on harvest – Great
Famine 1315 – 1316 (10% pop died)
Ergotism (Rye); polluted stream
water (animals); fulling used urine;
small beer and cider; pottage
No chimneys, so smoke in huts
Middens in gardens; a few houses
had cess-pits – holes otherwise!
For townsfolk:
Open markets and open shops
Conduits (fountains) in market squares
Public latrines in many town squares
Waste from food in streets and dung from
animals
Butchers; masons; dyers; masons created
environmental problems
Smell; cramped living conditions; water bought
from water carriers; a few had pipes or wells
Latrines; gongfermers
Responses to the Black Death:
When? 1348/49; 50% pop died
Causes:
Rats and fleas for bubonic plague
but also septicemic and pneumonic
No cure – so some unusual
responses, e.g. Camomile; opening
Veins; live toads and chickens
Lots of supernatural responses
that reflected the power of the Church
e.g. flagellants; priests urged people
to confess their sins;
Some used astrology; unbalanced
humours or miasma to explain plague
Huge impact! Everyone affected by
death toll, but hit towns especially
hard
Although King Edward III wrote a
letter to the Lord Mayor of London
requesting the streets to be cleaned,
the government did little to intervene.
Plague revisited in

2. Public health in the Middle Ages:
Church authorities:
Monasteries had high standards of hygiene
(Fountains Abbey). It had an infirmary for the sick
and latrines
Cathedrals laid pipes to bring in fresh water
Why? They had the wealth (tithe)
For town authorities:
Some towns did try to deal with problems of
public health, e.g. Bristol passed laws in 14th C
for dungheaps to be moved outside; York 1301
King Edward I ordered the authorities to clear filth
from the streets; 1329 Winchester’s butcher’s
guild appointed 2 people to check the quality of
meat.
In London there was piped spring water from
the 1230s. Further measures were taken in the
15th Century, e.g. 1415: Mayor of London ordered
The rebuilding of a latrine; 1417; as plague struck,
London closed public baths
However, government involvement in public
health was minimal!
Responses to the Great Plague:
When? 1540s; 1550s; especially 1665
Same symptoms as Black Death
Mostly struck in summer months
Poor in towns hit the most
STILL nobody understood it!
BUT never returned after 1667
1518 Henry VIII proclaimed that houses that were infected by plague should be identified with bundles of straw.
1578 Elizabeth I ordered the printing of Plague Orders - prayers should be said in church, no cats or dogs should be allowed on the streets, clothing of plague victims should be burned, and infected house should be shut for six weeks
1604 Parliament passed the Plague Act.; ordered towns to collect money to help the sick. Plague victims found out of their house could be hanged. Healthy people leaving and infected house could be whipped.

3. Write a clear and well organised summary that analyses people’s living conditions in the Middle Ages. Support your summary with examples.
How will you analyse?

4. When did the most important changes in public health take place – 20th Century or 19th century?
Problems - first half of 19th century?
M _______
I ___________ R ___________
U ____________n
K ______ C _________ 18 __
B ____ to B ______ T _________s
W ______ Com _______
W ______ P _______s
C ____ P ___ s
R ______ T _________ (London)
Problems – early 20th century
P______y & P ____ L ______ C _________s
(Charles B _____ & Seebohm R _______)
Poor d ____t
Poor could not afford a D _______
People had to w ____ into O___ A ___.
1918: S ________ F ___
Solutions?
Canned foods (H _____ B _____ 1905)
No B ____ to B _____ housing to be built (1905)
The Liberal Part set up the W _______ S _____
This included O ____ A ___ P _______ (1908):
N __________ I ________ (1911)
H _______ A ___ (1919) (Homes fit for h _____s)
High building standards!
Solutions?
E_____ C_______’s report (1842)
The 1st P______ H _____ Act (1848)
(Not ___________)
In 1854 J_____ S_____ discovered?
The Summer of the G_____ S_____ (1858)
led J______ B_________ to?
The 2nd P_____ H______ Act (1875)
(Was __________)
Increase in C ____ P ______

5. When did the post important changes in public health take place – 20th Century or 19th century?
20th Century BUTs!
Housing:
Following 2nd World War, new H ____ R _____
F ___s built. These broke-up C ___________.
Food:
Rationing GOOD! After war, people’s eating habits
change with increased incomes. BUT …!
Scares like B _ _.
Air::
C____ + bad; S ___gs
1956: C _____ A ____ A ____
BUT! Pollution from D ______ C ____s
Cars & computers:
Inactivity leads to people being O ___________
(especially the P _____)
Epidemics
A ____s –growing complacency caused by mis-
understanding about A ____ R _______virals
NHS/Welfare State (1948
Healthcare for all at the “P ______ of D ________”
BUT in the late 20th Century …?

6. New technology: the most important factor in the development of public health in Britain?
ARGUMENTS FOR?
ARGUMENTS AGAINST?
Yes!
19th Century: J _______ B ________
London S ______s (pumping stations);
O ____ shaped pipes;
Increased use of flushing T _______s
especially early 20th C (T _____ C ______!)
BUT!
Not all new technology was good!
Steam (I ________ R _________) caused
atmospheric P ________
The M ______ C ____
People leading a S __________ lifestyle
as a result of new technology
Was new technology the ONLY FACTOR in
developing public health?
What about the role played by other factors?
E.G.
Individuals like:
L _____ P _______ and G ____ T _______
or J ____ S ____ and B _____ S _____
P ____
The role of Government
The V _____ (1862 and 1918)
1st and 2nd P ______ H _______ A ___s
L________ Government and O ___ A ___
P ______/N ________ I ________ (early
20th Century)
L _______ Party and NHS
Impact of WAR, e.g. R _________;
B _________ R ________ 1942

7. When did the post important changes in public health take place – 20th Century or 19th century?
Problems - first half of 19th century?
Miasma
Industrial Revolution
Urbanisation
King Cholera 1931 (Sunderland)
Back to Back Terraces
Water Companies
Water Pumps
Cess Pits
River Thames(London)
Problems – early 20th century
Poverty & Poor Living Conditions
(Charles Booth & Seebohm Rowntree)
Poor diet
Poor could not afford a Doctor
People had to work into Old Age.
1918: Spanish Flu
Solutions?
Canned foods (Heinz Beans 1905)
No Back to Back housing to be built (1905)
The Liberal Part set up the Welfare State
This included Old Age Pensions (1908):
National Insurance(1911)
Housing Act (1919) (Homes fit for heroes)
High building standards!
Solutions?
Edwin Chadwick’s report (1842)
The 1st Public Health Act (1848)
(Not compulsory)
In 1854 John Snow discovered?
The Summer of the Great Stink (1858)
led Joseph Bazalgette to?
The 2nd Public Health Act (1875)
(Was compulsory)
Increase in Civic Pride

8. When did the post important changes in public health take place – 20th Century or 19th century?
20th Century BUTs!
Housing:
Following 2nd World War, new High Rise
Flats built. These break-up Communities.
Food:
Rationing GOOD! After war, people’s eating habits
change with increased incomes. BUT …!
Scares like BSE.
Air::
Coal + bad; Smogs
1956: Clean Air Act
BUT! Pollution from Diesel Cars
Cars & computers:
Inactivity leads to people being Overweight
(especially the Poor)
Epidemics:
A IDSs –growing complacency caused by mis-
understanding about Anti Retrovirals
NHS/Welfare State (1948):
Healthcare for all at the “Point of Delivery”
BUT in the late 20th Century …?

9. New technology: the most important factor in the development of public health in Britain?
ARGUMENTS FOR?
ARGUMENTS AGAINST?
Yes!
19th Century: Jospeh Bazalgette
London Sewers (pumping stations);
Oval shaped pipes;
Increased use of flushing Toilets
especially early 20th C (Thomas Crapper!)
BUT!
Not all new technology was good!
Steam (Industrial Revolution) caused
atmospheric Pollution
The Motor Car
People leading a Sedentary lifestyle
as a result of new technology
Was new technology the ONLY FACTOR in
developing public health?
What about the role played by other factors?
E.G.
Individuals like:
Louis Pasteur and Germ Theory
or John Snow and Broad Street
Pump
The role of Government:
The Vote/franchise(1862 and 1918)
1st and 2nd Public Health Acts
Liberal Government and Old Age
Pensions/National Insurance (early
20th Century)
Labour Party and NHS
Impact of WAR, e.g. Rationing;
Beveridge Report 1942