Friday, July 20, 2007

Victorian Culture: Medicine and Mortality Rates

Victorian man preparing for foot surgery

During the 19th century, life expectancy at birth rose from about 35 to about 45. Medicine and surgery had little to do with this. Anesthesia and antisepsis improved a patient’s chance of surviving surgery, but most people didn’t die of conditions that surgery could help with. Medical treatment for infectious diseases, the major killers for most of the period, was ineffective at best. In fact, one of the major developments in medical was the statistical evaluation of therapeutic models, as in a study that showed death rates from pneumonia were 1 in 5 with bleeding, 1 in 5.5 with doses of tartar emetic (an antimony compound), and 1 in 13 with simple bed rest. The concepts of self-limiting diseases and supportive treatment emerged during this period, and at least stopped doctors from killing patients with heroic doses of heavy metals.

Anaesthesia used during a tooth extraction

Improved public sanitation was a major contributor to longevity. Sewer systems, street cleaning, and safe drinking water reduced the contagion and the prevalence of illness, starting in the 1840’s. By the 1850’s, most cities had boards of health, organized locally in English-speaking countries and nationally elsewhere. Bathing was revived between 1850 and 1875, at least for the upper and middle classes, whose servants could do the heavy work a bath required before indoor plumbing. Pasteur’s work on bacteriology gave scientific justification for new standards of cleanliness that were already emerging.

Individual being prepared for surgery

The collection of social statistics, pioneered by Babbage, Quetlet, and others of their era, led to the emergence of epidemiology. Disease carriers such as Typhoid Mary, unsafe wells, and other sources of contagion could be removed. This was undertaken on a large scale during the construction of the Panama Canal. The first attempt by the French in the 1880’s cost 25,000 lives, largely to yellow fever. The American attempt that completed the canal in the 1900’s lost fewer than 5,000, thanks to American health officers who wiped out the mosquitoes that carried the disease.

Child being vaccinated in France

Immunization became available for an increasing number of diseases. Doctors already gave smallpox vaccination sand scientists developed vaccines against anthrax and rabies. After 1905, mortality rates from childhood diseases already began to fall.
Finally, nutrition improved during the 19th century. The energy content (calorie value) of foods could be measured, using thermodynamic apparatus. Carbohydrates, fats, and proteins were recognized as energy sources, and the concept of trace nutrients began to emerge. Beriberi, rickets, and scurvy were identified deficiency diseases and chemists began trying to isolate and then to synthesize the “vitamines” that prevented them. The concept of a balanced diet was developed. Aside from preventing deficiency diseases, better nutrition led to overall improvement in health.

Stoddard, W.H. (2000) - Gurps Steampunk, pg. 65-66, SJG:Austin
[edited for removal of game specific content]


Amber_Palowakski said...

Very informative article, Dr. Fabre, thank you for sharing!

Dr. Rafael Fabre said...

Ty, madam!