1800-1849

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1800    The Population Act (41 Geo.lll c.1 5) enabled “an account of the population of Great Britain to be taken”. Until 1920 an act had to be passed prior to each census. See 1801.

    College of Surgeons of London founded. See 1843.

1801    The first census of the population of England and Wales was carried out on March 10th by a house-to-house enquiry together with returns of baptisms and burials between 1700 and 1800, and marriages between 1754 and 1800 as supplied by the clergy. The details included the number of inhabited and uninhabited houses, the number of families occupying the former, the number of persons of each sex, and the numbers of people employed in agriculture, trade, manufacture or handicrafts. The enumerators in England and Wales were the overseers of the poor, local clergy or other substantial householders; in Scotland they were the schoolmasters. The local returns were statistical summaries only, made in a prescribed form and attested before the justices of the peace. The first abstracts and reports of the results of the census were compiled by John Rickman (1771-1840, clerk in the House of Commons) and published in December. The population in England and Wales was counted as 8·9 million, but if allowance is made for under-recording the total was estimated at 9.2 million.

    First General Enclosure Act (41 Geo llI c.1 09). Enclosure of land had been going on for centuries, but had increased substantially during the last two decades of the eighteenth century. Private acts of Parliament were passed which overrode objections to the enclosure, often at the expense of the poor. The act of 1801 was designed to standardise and simplify the procedures for obtaining private acts by setting out standard clauses that could be incorporated by reference in private bills and allowing affidavits to be accepted as evidence. See 1821.

1802    Health and Morals of Apprentices Act (42 Geo.lll c.73) limited the work of children in textile mills to 12 hours per day; prohibited night work; required minimum standards of accommodation; some elementary education to be provided; factories to be periodically lime washed; and infectious diseases attended to and reported. The act attempted to enforce on all employers the conditions provided by the more humane mill-owners. Enforcement was in the hands of the local justices of peace who varied in the rigour with which they carried out these duties. See 1819.

    Vagrants Acts (43 Geo llI c.6 & 47) exempted discharged soldiers and sailors from parts of previous legislation concerning begging.

    London Fever Hospital established with the support of the parishes, which agreed to pay for the upkeep of patients admitted on the order of the admitting officer.

    Start of the Union Ironworks’ Butetown in Rhymni Valley, Glamorgan. See 1847.

1803    “Medical Ethics” by Thomas Percival (see 1796) published in London. It had been published for private circulation in 1794.

1804    Steam railway locomotive developed by R Trevithick (1771-1833). See 1825.

1805    Resumption of the Napoleonic Wars; Battle of Trafalgar, 21 October.

    A Central Board of Health, as earlier advocated by Richard Mead (see 1720), established by royal proclamation to advise the Government how to ward off the yellow fever, which around this time was ravaging the southern shores of Spain. The Board, composed mainly of fellows of the London Royal College of Physicians, pressed for quarantining of all ships coming from places known to be infected, and for a permanent central organisation. With the ending of what became known as the “Gibraltar Sickness” the Board ceased to function in 1806. See 1831.

    The Medico-Chirurgical Society of London founded. In 1834 a Royal Charter was granted and in 1907 the Society became the Royal Society of Medicine.

    The Edinburgh Medical and Surgical Journal first published.

    John Dalton (see 1794) discovered the law of chemical combinations and tabulated the atomic weights of various elements.

1807    A Select Committee recommended that an asylum for lunatics should be set up in each county. Each asylum should have a committee of governors nominated by the local magistrates (justices of peace) and be financed by a county rate. See 1808.

    Andrew Duncan (1773-1832, son of Andrew Duncan referred to in 1790) appointed to the first chair of Medical Jurisprudence in Edinburgh University.

1808    County Asylums Act (4.8 Geo.lll c.96) for “the better Care and Maintenance of Lunatics being Paupers or Criminals” enabled counties to construct asylums for the insane. See 1827.

    National Vaccination Board established under the auspices of the Royal College of Physicians of London to encourage vaccination. Parliament subscribed £2000 per year. See 1840.

1809    ‘Treatise on Medical Police” by John Roberton (1776-1840) published in Edinburgh. The term “general practitioner” used for the first time in its modem sense in a letter in the

    Medical and Physical Journal. Later, in 1814, a letter in the London Medical, Surgical and Pharmaceutical Repository stated: “A general practitioner is indubitably of infinite importance to the commonwealth: as society is constituted he cannot be dispensed with; and therefore ought to be encouraged and protected”.

1811    Census on 27 May, conducted on the same lines as for 1801, estimated the population of England and Wales at 10·2 million.

    National Society for Promoting the Education of the Poor in the Principles of the Established Church set up by the Church of England to provide schools. In 1814 the British and Foreign Schools Society was set up by non-conformists. See 1833.

1812     “New England Medical Review and Journal” (later the “New England Journal of Medicine”) first published.

1814    Mount Street School of Anatomy founded in Manchester; the first medical school in England outside Oxford, Cambridge and London. See 1851.

    The Royal Medico-Chirurgical Society, Glasgow, founded.

1815    Battle of Waterloo.

    Apothecaries Act (55 Geo.lll, c.194) for the “better regulating the Practice of Apothecaries throughout England and Wales”, introduced compulsory apprenticeship and formal qualification; and gave the Society of Apothecaries the right to examine and licence apothecaries. Subsequently the licentiateship (LSA, changed to LMSSA in 1907) became the commonest qualification among general practitioners, although by 1840 it has been estimated that only about a third of those practicing medicine were qualified by examination. See 1834.

    Poor Law Act (55 Geo.lll, c.137) extended the power to give outdoor relief. See 1819.

    Select Committee on Madhouses was set up following the exposure of cruelty and abuse in Bethlem and other asylums. Substantial evidence of appalling treatment was collected and presented to Parliament in 1816 with a recommendation for legislation. Bills were passed by the Commons in 1816,1817 and 1819, but rejected by the Lords on each occasion. See 1828.

    Income tax withdrawn. See 1842.

    Corn Law (55 Geo.lll, c.26) prohibited the importation of corn into Britain until the home price reached 80 shillings per quarter. The cost of a four pound loaf of bread in London averaged over one shilling between 1816 and 1818. See 1846.

1817     Typhus epidemic in Edinburgh.

1818    Regulation of Parish Vestries Act (58 Geo.lll, c.69) set rules for the conduct of meetings; disenfranchised persons who had not paid their rates; gave votes to non-resident occupiers; and introduced plural voting. See 1831.

    Foundation of Charing Cross Hospital, London.

1819    Massacre of Peterloo. Thousands of workers from Manchester and the surrounding cotton mills gathered peacefully at St Peter’s Field, to be addressed by their leaders, were savagely dispersed by the local yeomanry and regular cavalry acting on orders from the magistrates. Eleven civilians were killed and over 400 wounded.

    Poor Relief Act (59 Geo.lll, c.12), Sturges Bourne Act, attempted to ensure that property owners had an influential say in the conduct of poor relief; gave parishes optional power to hire paid officers (assistant overseers), and to establish a formal procedure whereby they might elect committees to supervise the work. See 1834.

    Cotton Mills and Factories Act (59 Geo.lll, c.66) prohibited children under the age of nine years from working in cotton mills, and restricted those over the age of nine to a 12 hour day. Enforcement was in the hands of local magistrates. The act owed much to the efforts of Robert Owen (see 1799). See 1833.

    John McAdam (1756-1836) introduced solid road surfaces. In 1820 he published “Present State of Road Making” and in 1827 was appointed general surveyor of roads.

    James Cleland (1770-1840) persuaded the Glasgow authorities to establish a register of deaths to be kept by the wardens of burial grounds. In 1820 he persuaded the magistrates of the City to conduct a voluntary enumeration of its inhabitants to include details of sex, age, country of origin, duration of residence, occupation, religion and status. Cleland was a pioneer in understanding the need for detailed and accurate denominator data in calculating rates of the occurrence of events. See 1833.

1820    Street lighting installed in Pall Mall, London.

1821     Census carried out on 28 May as for 1801 with the addition of recording people’s ages. Population of England and Wales estimated to be 12 million.

    Inclosure Act (1&2 Geo.IV, c.23) (note spelling) strengthened the rights of landlords to take over land allotted to them by the Commissioners. See 1836.

    Steamships introduced on the Dover-Calais route.

1823    Thomas Wakley (1795-1862) founded The Lancet.

    Capital punishment abolished for minor offences. See 1838.

    George Birkbeck (1776-1841, physician) founded Glasgow Mechanics Institution; and in 1824 the Mechanics Institution, London (later Birkbeck College). He was a founder and councilor of University College, London. See 1826.

“An Essay on the Education and Duties of General Practitioners in Medicine and Surgery” by Thomas Alcock (1784-1833) published in the Transactions of the Associated Apothecaries and Surgeon-Apothecaries of England and Wales.

Veterinary College established in Edinburgh by William Dick (1794-1866).

    Dr. (later Sir) Alexander Morison (1779-1866) initiated a course of lectures on mental disorders, the first such course in Great Britain.

1824    Vagrants Act (5 Geo.IV, c.83) amended the definitions of idle and disorderly persons, rogues and vagabonds; set out powers of searching persons and premises; and prescribed maximum penalties and terms of imprisonment.

    Gaol Act (5 Geo.IV, c.12) attempted to improve conditions in prisons. See 1835. Manchester Institute of Science and Technology founded.

1825    Juries Act (6Geo.IV, c.50) set out the qualifications for a juror as a man aged over 21 and less than 60 years who was a householder. See 1919 and 1965.

    Cotton Mills and Factories Act (6 Geo.IV, c.63) limited the hours of work of children under the age of 16 years to 12 per day between 5.0 am and 8 pm with ½ hour off for breakfast and 1 hour off for lunch; and forbade any justice of the peace who was a proprietor or master of a mill or factory to act as a magistrate in matters connected with this act.

    Stockton-Darlington railway, the first passenger steam railway, opened.

1826    University College, London, founded as a proprietary company; opened in Gower Street two years later.

1827    Bribery and Corruption in Elections Act (7&8 Geo.IV, c.37) stated that persons employed by candidates at elections were to be disqualified from voting; and that cockades and ribbons were not to be given to voters by candidates.

    Select Committee appointed to consider the state of pauper lunatics from the metropolitan parishes. See 1828.

1828    The Test Act of 1633 and the Corporation Act of 1661 repealed (9 Geo.IV, c.17), thereby removing the necessity of receiving the Sacrament of the Lord’s Supper as a qualification for certain state and municipal offices. Thus Catholics and Dissenters were no longer debarred from such offices.

    County Asylums Act ((9 Geo.IV, c.40) was largely a consolidating act. It introduced standard records which were to be forwarded by justices of the peace to the Home Department, and the Secretary of State acquired powers to send inspectors to any asylum. See 1842.

    Care and Treatment of Insane Persons Act (9 Geo.IV, c.41) (The Madhouse Act) set up the Metropolitan Commission in Lunacy and charged the Commissioners with the duty of inspecting private asylums in London, previously the responsibility of the Royal College of Physicians. See 1832.

    Edwin Chadwick (1800-1890) published “The Means of Assurance against the Casualties of Sickness, Decrepitude, and Morality” in the Westminster Review, in which he urged that it was the duty of Government to collect accurate statistics about sickness and death. See 1836 and 1842.

    Royal Free Hospital, London, founded.

    Glasgow Medical Journal first published.

1829    Catholic Emancipation Act (10 Geo.IV, c.7) gave civil rights to the Catholics. 

    Apothecaries allowed to claim remuneration for advice and attention as well as for medicines supplied (see 1703).

    King’s College, London, founded; opened in the Strand in 1831.

    Thomas Burke hanged in Edinburgh for ‘body snatching’, his colleague, William Hare was imprisoned having turned King’s evidence. Since the early days of the 18th century there had been a traffic in dead bodies for dissection. The demand stimulated the nefarious activities of the ‘Resurrectionists’ who robbed recent graves. Burke and Hare murdered and then sold the bodies of their victims. See 1832.

1830    Publication of “A Treatise on Fevers” by Thomas Southwood Smith (1788-1861; adviser, later a member of the first General Board of Health, 1848; grandfather of Octavia Hill, see 1865).

    The Metropolitan Society of General Practitioners in Medicine and Surgery instituted, but its existence was short-lived.

    Creation of the Metropolitan Police by Sir Robert Peel. See 1835.

    “Rural Rides”, by William Cobbett (1762-1835, essayist and politician), published, in which he described the plight of the rural poor.

    Discontent and fear exploded throughout south and east England as agricultural labourers and others destroyed threshing machines and burned barns and ricks. They made their demands known to farmers and gentry by petitions and threats signed “Captain Swing”.

1831    Census on 30 May. Population of England and Wales estimated at 13·9 million. 

    Cholera and influenza epidemics. Cholera had broken out in Asia and gradually spread across Europe.

    A Consultative Board of Health set up, composed of the President and five fellows of the Royal College of Physicians, the Superintendent-General of Quarantine, the Director-General of the Army Medical Department, the Comptroller of the Navy, the Medical Commissioner of the Victualling Office and two non-medical civil servants. The Board issued a series of recommendations in the form of Sanitary Regulations. Later in the year it was replaced by a Central Board of Health which called for the establishment of local boards of health composed of one or more magistrates, a clergyman, a number of substantial householders and one or more medical men. The local boards were to appoint district inspectors to report on the food, clothing and bedding of the poor, the ventilation and sanitation of their dwellings, space, means of cleanliness and their habits of temperance; houses were to be whitewashed. The Boards were to endeavour to remedy, by every means which individual and public charitable exertion can supply, such deficiencies as may be found. Over 1,200 local boards were established by Orders in Council, many continued after 1832 when the Central Board was disbanded. See  1848.

    An Act prohibited in certain trades the payment of wages in goods, tokens or otherwise than in the current coin of the realm (1 &2 WilI.IV, c.37), became known as the Truck Act.

    Cotton Factories and Mills Act (1 &2 Will.IV, c.39) limited the working day of people under the age of 18 years to 12 hours per day, and not more than 9 hours on a Saturday. See 1833.

    Better Regulation of the Vestries Act (1&2 Will.IV, c.60), enabled those vestries which so chose to introduce universal suffrage, annual elections of one third of the members and a single vote (see 1818). The clauses were rarely adopted.

    Land tax ceased to be collected.

    “The Effects of the Principal Arts, Trades, and Professions, and of Civil States and Habits of Living on Health and Longevity”, by Charles Turner Thackrah (1795-1833) published. In addition to his detailed studies of industrial diseases, Thackrah was active in the foundation of the Leeds School of Medicine. “A study of medicine”, he wrote, “which disregards the prevention of diseases limits its utility and its honours”.

    The British Association for the Advancement of Science founded.

1832    Local cholera epidemics continued, by June there had been 22,000 deaths.. 

    Reform Act (2&3 WilI.IV, c.45) was the first reform of Parliamentary elections; enfranchised the urban middle class; and abolished the “rotten boroughs”.

    Cholera Act (2 Will.IV, c.10) and Cholera (Scotland) Act (2 Will.IV, c.1 1) enabled the Privy Council to make orders for the prevention of cholera provided that any expense incurred should be defrayed out of money raised for the relief of the poor by the parishes and townships. Powers lapsed at the end of 1834.

    Insane Persons and Asylums Act (2&3 WilI.IV, c.107) transferred the inspectorate of the Metropolitan Commissioners to the Lord Chancellor, but left the county asylums under the supervision of the Secretary of State. See 1844.

    Schools of Anatomy Act (2&3 WiIl.IV, c.75) arose out of the scandals of the ‘body snatchers’ (see 1829). The Act provided for the use of unclaimed bodies in poor law institutions for teaching purposes and introduced licensing and inspection of schools of anatomy.

    Report of the Select Committee on the Bill for the Regulation of Factories (chairman, Sir Michael Sadler) described appalling conditions, excessive hours of work and cruelty to children in factories. See 1833.

    Provincial Medical and Surgical Association founded at Worcester by Dr (later Sir) Charles Hastings (1794-1866), in 1855 it became the British Medical Association.

    Durham University received its charter.

    Bristol Medical School founded.

    Manchester Statistical Society founded.

    York Medical Society founded.

    “The Moral and Physical Condition of the Working Classes employed in Cotton Manufacture in Manchester”, by JP Kay (1804-77, later Sir James Kay-Shuttleworth), published. See 1838.

1833    Abolition of slavery.

    Mills and Factories Act (3&4 WiIl.IV, c.103) (Althorp’s Act) repeated and extended the act of 1831. Younger children were to attend school for at least two hours on six days a week, and holidays for the children and young persons to be all day on Christmas Day and Good Friday, and eight half days. The Act gave powers for the appointment of inspectors, because provisions of previous acts “were not duly carried into execution , and the Laws for the Regulation of the Labour of Children in Factories have been evaded”. The inspectors were empowered to enter any factory at any time and to examine therein the children and other young persons and to enquire about their condition, employment and education. Children under the age of 13 years had to be certified by a physician or surgeon as being “of the ordinary strength and appearance” of a child of his/her stated age. See 1844.

    Burgh Reform Act (3&4 Will.IV, c.46) reformed the Burghs in Scotland and enabled them to establish a general system of police.

    For the first time the Government allocated a grant of £20,000 towards erecting Church of England schools (later extended to Catholic and Non-Conformist schools), provided that at least half of the cost of the building had been raised by private subscription. See 1839.

    A Select Committee of the House of Commons recommended state registration of births, marriages and deaths. See 1836.

    University College Hospital, London, founded.

    “The Manufacturing Population of England. Its Moral, Social and Physical Condition”, by P Gaskell, published.

1834     Poor Law Amendment Act (4&5 WilI.IV, c.76) followed the publication of the Report of the Royal Commission on Poor Law (see 1832). The Act limited outdoor relief to the aged and infirm who were “wholly unable to work”; encouraged the building of workhouses, and introduced a spartan regime and the “Workhouse Test”; and considered any relief given to be a loan. The Act required wards to be set aside for the impoverished sick and empowered justices of the peace to give an order for medical relief to any poor person with “sudden and dangerous illness”. The Act set up the Poor Law Commission to consist of three commissioners to supervise the implementation of the act, the first secretary of the Commission was Edwin Chadwick (1800-90). Boards of Guardians were encouraged to combine into Unions to build the workhouses. Disraeli proclaimed that the new law was “announcing to the world that in England poverty was a crime”. See 1844.

    Chimney Sweeps Act (4&5 WiII.IV) forbade the apprenticing of any boy under the age of 10 years, and the employment of children under 14 in chimney sweeping unless they were apprenticed or on trial. The apprentices were not to be “evil treated” by their employers, and any complaints of the children were to be heard by justices of the peace. The act was largely ineffective as there were no means of enforcement. See 1840.

    The House of Commons appointed a Select Committee to “inquire into the laws, regulations, and usages regarding the education and practice of the various parts of the Medical Profession in the United Kingdom”. Bills to reform the profession were unsuccessfully introduced in 1844 and 1845. See 1858.

    The Statistical Society of London founded; later the Royal Statistical Society. See1857.

    Manchester Medical Society founded.

    Medical School founded at Newcastle-upon-Tyne, which became associated with the University of Durham in 1852.

    The Tolpuddle martyrs, six agricultural workers in Dorset, were transported for taking oaths when forming a local branch of the Friendly Society of Agricultural Workers.

    Death of Thomas Telford (b.1757), engineer concerned with roads, harbours, canals, bridges and aqueducts. A Founder and first President of the Institute of Civil Engineers in 1818.

1835    Highways Act (5&6 WiIl.IV, c.50) consolidated and amended the law relating to highways in England (see 1773); forced labour for the maintenance of parish roads was abolished, and work on parish roads to be financed by the rates and on trust roads by tolls. See 1844.

    Municipal Corporations Act (5&6 Will.IV, c.76) reformed the organisation and procedures of the boroughs; required the corporations to be elected by the ratepayers, to hold meetings open to the public and to have their accounts audited. The towns were given power to appoint their own police forces. The vestries or parish councils continued to appoint surveyors of highways and overseers of the poor. In 1842 justices of the peace were given power to appoint paid parish constables. See 1847, 1856 and 1882.

    Central inspectorate of prisons introduced.

    “Philosophy of Health”, a popular exposition of hygienic principles by Thomas Southwood Smith (see 1830), published.

    Thomas Hodgkin (1798-1866, pathologist at Guy’s Hospital until 1837) published his lectures on the preservation of health and the prevention of disease given at the Mechanics Institute of Spitalfields. Hodgkin devoted the second half of Ns life to the causes of oppressed peoples throughout the world.

1836    Influenza pandemic.

    Births, Deaths and Marriages Registration Act (6&7 Will.IV, c.86) introduced registration of births, deaths and marriages but contained no penalties for refusal to register; established the General Register Office; and divided the country into registration districts. Registration became effective from 1st July 1837. TH Uster (1800-42, novelist and dramatist) was appointed the first Registrar-General. For similar action in Scotland see 1854. See 1874.

    Inclosure Act (6&7 WiII.IV, c.1 15) set out the procedures for enclosing open and arable fields. See 1845.

    Tithes Commutation Act (6&7 WiIl.IV, c.71) ended the need for farmers to supply local clergymen with payments in the form of grain.

    A permanent Ecclesiastical Commission, consisting of Anglican bishops, laymen and cabinet ministers, set up to end abuses in the Church and to reduce the anomalies of wealth among bishoprics and parishes.

    London University established by charter as the examining body with power to grant degrees to students from University College (1828) and King’s College (1831) in the faculties of arts, law and medicine. The first examination for MB was held in 1839.

    National Orthopaedic Hospital founded.

1837    Start of a smallpox epidemic which continued until 1840, causing an estimated 42,000 deaths. There was also an outbreak of typhus in London.

    Royal College of Art founded.

1838     A Committee of the Privy Council established to oversee elementary education and grant aid to voluntary schools. Dr James Kay (see 1832) was appointed secretary and the first two school inspectors were appointed.

    Report by Dr Neil Arnott (1788-1874) and Dr James Kay (above) and another by Dr Southwood Smith (see 1830) exposed the extent of preventable disease and the dreadful living conditions under which people existed in Manchester and London respectively.

    A People’s Charter was adopted by delegates from all parts of the country at a meeting in Birmingham. It called for universal manhood suffrage; annual parliaments; voting by secret ballot; equal electoral districts; abolition of property qualifications for MPs; and payment of MPs. “The House of Commons is the People’s House, and there our opinions should be stated, there our rights ought to be advocated, there we ought to be represented or we are serfs”.

    William A Guy (1810-1885) appointed professor of medical jurisprudence (later of hygiene) at King’s College, London. See 1844 and 1878.

    The English Agriculture Society (from 1840 the Royal Agriculture Society of England) founded to apply science to agriculture.

    Capital punishment retained only for murder and treason. See 1868.

1839    The Government grant to the two educational societies (see 1833) was increased to

    Dr William Farr (1807-1883) appointed compiler of abstracts at the General Register Office. He introduced the first classification of causes of death. In his first report Farr wrote “medicine, like other natural sciences, is beginning to abandon vague conjecture where facts can be accurately determined by observation; and to substitute numerical expressions for uncertain assertions.”

    Dr R Cowan (1796-1841) appointed as the first professor of forensic medicine at Glasgow University.

    King’s College Hospital, London, founded.

1840     Vaccination Act (3&4 Vict, c.29) made free vaccination available as a charge on the poor rates. Vaccination was, thereby, the first free health service provided through legislation on a national scale and available to all. See 1841.

    Grammar School Act (3&4 Vict., c.77) gave the Chancery Court power to alter the original statutes of grammar schools to meet new needs.

    Chimney Sweeps Act (3&4 Vict., c.85) prohibited any child under the age of 16 years being apprenticed, and any person under 21 being compelled or knowingly allowed to ascend or descend a chimney or flue for sweeping, cleaning or coring. See 1864.

    Start of the publication of the Registrar-General’s Weekly Returns of deaths in London.

    Report of the Select Committee on the Health of the Towns (chairman, RA Slaney 1792-1862) exposed squalid conditions in many industrial areas and recommended the institution of district boards of health: “The principal duty and object of these boards of health would be precautionary and preventive, to turn the public attention to the causes of illness, and to suggest means by which the sources of contagion might be removed.”

    “Observations on the Management of the Poor in Scotland and Its Effects on the Health of the Great Towns”, by WP Alison (1790-1859, successively professor of medical jurisprudence, physiology and medicine in Edinburgh), published. Alison favoured the contagion theory of disease and focused attention on destitution as the chief cause of misery, overcrowding and disease. See 1938.

    “The Provincial Medical and Surgical Journal” first published on 3rd October. In 1853 it merged with the” London Journal of Medicine” and its name was changed to the “Association Medical Journal”, and in 1857 to the “British Medical Journal”.

    Universal penny post introduced for letters throughout the UK.

1841     Census on 6 June, the first to be conducted by the Registrar-General, counted the population of England and Wales to be 15·9 million, thirty six per cent of whom were aged under 15 years and four per cent were 65 or more. In England and Wales the newly appointed local registrars were responsible for conducting the census and each head of the household for completing the enumeration form for his/her family. In Scotland the official schoolmaster or other fit person was responsible for the census locally. Details of birthplace, nationality and occupation of individuals were obtained.

    Vaccination Act (4&5 Vict., c.32) declared that vaccination should not be considered as “parochial relief” and that no person shall by reason of vaccination be deprived of any right or privilege or be subject to any disqualification whatsoever. See 1853.

    Association of Medical Officers of Asylums and Hospitals for the Insane formed. In 1865 the name was changed to the Medico-Psychological Association (in 1925 became Royal) and in 1971 it became the Royal College of Psychiatrists.

    The Pharmaceutical Society of Great Britain founded (incorporated by Royal Charter in 1843). “The Pharmaceutical Journal” began publication under Jacob Bell (1 81 0-59). See 1852.

1842    Justices of the peace were permitted to appoint paid constables (5&6 Vict., c.109). Lunatic Asylums Act (5&6 Vict., c.87) gave power to the Metropolitan Commissioners (see 1828) to inspect, twice yearly, all asylums and madhouses in the country whatever their legal status. See 1845.

    Mines and Collieries Act (5&6 Vict., c.99) was introduced after a Royal Commission had revealed the terrible conditions in which women and children worked underground. It prohibited the employment underground of women and children under ten in mines and collieries, and provided for the appointment of inspectors of mines. See 1850.

    Report of the Sanitary Condition of the Labouring Population of Great Britain published. Written by Edwin Chadwick (see 1834), the report detailed grossly insanitary conditions and related these to the incidence of diseases and deaths; and contrasted the life expectancy in the different social classes. It established the association between squalor, lack of sanitation and overcrowding to endemic and epidemic diseases. The report recommended sanitary engineering and extending the duties and training of district medical officers. “The wants, however, which it is a duty to represent and repeat, as the most immediate and pressing, for the relief of the labouring population, are those of drainage, cleansing, and the exercise of the business of an engineer, connected with the commissions of sewers, to which the service of a board of health would be auxiliary”. “A medical man who is restricted to the observation of only one establishment may be said to be excluded from an efficient knowledge even of that one. Medical men so restricted are generally found to possess an accurate knowledge of the morbid appearances, or of the effects among the people of the one establishment, but they are frequently found to be destitute of any knowledge of the pervading cause in which they are themselves enveloped, and have by familiarity lost the perception of it”. Chadwick’s report led to the Royal Commission for Inquiry into the State of Large Towns and Populous Districts set up in 1843. See 1849.

    Report on the Sanitary Condition of the Labouring Population of Scotland published.

    A General Medical Order providing guidance for the establishment of a comprehensive medical system for “the poor” received widespread opposition from Boards of Guardians.

    The School of Pharmacy in London founded; in 1925 it became a school of London University.

    “The Asylum Journal” was started by Sir John Charles Bucknill (1817-97, medical superintendent of the Devon County Asylum). The name was changed to Asylum Journal of Mental Science in 1843, and to “Journal of Mental Science” in 1848.

    Ether vapour used by CW Long (1815-78) for the first time as an anaesthetic. See 1846.

    Income tax re-introduced (see 1815) “temporarily” at seven pence in the pound on incomes over £150 per year.

1843    Influenza pandemic.    

    The College of Surgeons of London (see 1800) became the Royal College of Surgeons of
England.

    Farr (see 1839), in the annual report of the Registrar-General, pointed out the number of
deaths caused by puerperal fever spread by doctors and attendants.

    “Diseases of the Lungs from Mechanical Causes and Inquiries into the Condition of the
Artisans exposed to the Inhalation of Dust”, by C Holland, published.

1844     Poor Law Amendment Act (7&8 Vict.., c.1 01) introduced changes in the election of
guardians and empowered mothers of illegitimate children to apply to justices in petty sessions
for a maintenance order against the father. See 1845.

    Labour in Factories Act (7&8 Vict.., c.15) amended the regulations concerning factory
inspectors and certifying surgeons; for the first time machinery was required to be guarded; the
age at which children may be employed was reduced from nine to eight years; and the
maximum hours of work for children and women was prescribed. See 1847.    

    Interim Report of the Royal Commission on the State of Large Towns and Populous
Distincts (Health of the Towns Commission), was published. See 1845.

    Report of the Metropolitan Commissioners in Lunacy (chairman, Lord Ashley, 1801 -85,
later Lord Shaftesbury), criticised the management of asylums; called for a uniform system of
inspection by a statutory authority; reform of certification; and separate accommodation for
incurable pauper lunatics so that the asylums could concentrate on the treatment of curable
cases. See 1845.

    Reports of the Select Committee on Poor Law Medical Relief (chairman, Lord Ashley)
outlined a comprehensive picture of current practice; opposed the requirement for a relieving
officer to determine need and eligibility for medical attention; and favoured direct access to a
medical officer. No change followed the report. See 1861.

    The Health of the Towns Association established (11 December) for the purpose of
diffusing among the people the information obtained by recent inquiries as to the physical and
moral evils arising from existing insanitary conditions and to “substitute health for disease,
cleanliness for filth, order for disorder, economy for waste, prevention for palliation, justice for
charity, eniightened sell-interest for ignorant selfishness and to bring to the poorest and
meanest - Air, Water, Light”.

    Ragged School Union and London School Mission formed to provide schooling for those
unable to pay the “school pence” demanded by voluntary schools.

    Turnpike Trusts numbered about 1000, and were receiving about £1.5 million in tolls p.a
Royal College of Veterinary Surgeons formed.

    “On the Value of Numerical Methods as applied to Science, but especially to Physiology
and Medicine”, and “Principles of Forensic Medicine”, by WA Guy (see 1838), published.

1845
    Lunatics (Care and Treatment) Act (8&9 Vict., c.100) and Regulation of Asylums Act
(8&9 Vict.., c.126) improved the procedure for certification; and set up a Board of
Commissioners (chairman, Lord Ashley) to inspect and supervise asylums and other places
where mentally ill people were cared for.

    Poor Law Scotland (Amendment) Act (8&9 Vict.., c.83) retained the parish as the unit of
administration with parochial boards consisting of elected representatives and, ex officio, the
chief magistrate as the manager. Each board had to appoint an inspector of the poor who had
direct control of relief and could only be dismissed by the central Board of Supervision, also set
up by the act. Relief was limited to the aged and infirm poor. Parochial boards were permitted to
subscribe to any public infirmary, lying-in-hospital, asylum or dispensary and were required “to
provide for medicines, medical attendance, nutritious diet, cordials, and clothing for such Poor,
in such manner and to such extent as may seem equitable and expedient; and it shall be lawful
for the parochial board to make provision for the education of poor children who are themselves
or whose parents are objects of parochial relief”. See 1847.

    Inclosure and Improvement of Commons Act (8&9 Vict.., c.1 18) set up Inclosure
Commissioners to supervise and remedy defective or incomplete actions taken under previous
inclosure acts and the many private acts.

    Museums Act (8&9 Vict., c.43) permitted local authorities to build museums and charge
up to one penny for admission.

    Final Report of the Health of the Towns Commission (see 1844) published. It
recommended the creation of a new government department and that the arrangements for
drainage, paving, cleansing and water supply should come under one administration in each
locality. The Report deplored the extent of overcrowding; called for a central inspectorate of
housing; and recommended that local authorities should be able to demand that landlords clean
and repair properties dangerous to public health. The Report led to the Public Health Act 1848,
see also 1868.

    The Select Committee on Smoke Prevention, appointed in 1843, reported. For the first
time serious attention was given to air pollution.

    Queen’s University, Belfast and St Mary’s Hospital, London, founded.

    Potato blight in Ireland caused widespread famine; recurred until 1849 resulting in high
mortality and emigration. Scotland was also affected with similar results.

1846    Removal of Nuisances and Prevention of Epidemic Diseases Act (9&1 0 Vict.., c.96) set
out procedures for the more speedy removal of nuisances when certified as such by two
medical practitioners; and empowered the Privy Council to make regulations for the prevention
of contagious diseases. See 1849.   

    Improvement of the Sewerage and Drainage of Liverpool Act (9&1 0 Vict.., c.1 27), known
as the Liverpool Sanatory (sic) Act, was the first comprehensive sanitary act in Great Britain. It
gave authority for a “medical officer of health” to be appointed: “It shall be lawful for the said
Council to appoint, subject to the approval of one of Her Majesty’ Secretaries of State, a legally
qualified medical practitioner of skill and experience to inspect and report periodically on the
sanitary state of the said borough, to ascertain the existence of diseases, more especially of
epidemics increasing the rate of mortality, and to point out the existence of any nuisances or
other local causes which are likely to originate and maintain such diseases, and injuriously
affect inhabitants of the said borough , and so to point out the most efficacious means for
checking and preventing the spread of such diseases and such person shall be called the
Medical Officer of Health for the Borough of Liverpool.”

    Public Baths and Wash-houses Act (9&1 0 Vict.., c.74) enabled local authorities to provide
these amenities.

    The Government took on most of the costs of training school teachers, although the
training colleges remained denominational. A pupil-teacher system was adopted whereby, in
schools approved by an inspector, children aged 13 years could be apprenticed to a teacher for
5 years and, after passing an examination, could attend a training college for three years.
Bill presented unsuccessfully in Parliament to repeal the corn laws. See 1847.

    A Select Committee of Parliament was set up to inquire into the over-harsh and
inhumane treatment of paupers in the Andover Workhouse.

    Convention of Poor Law Medical Officers founded.

    American Medical Association formed.

    Ifnaz Semmelweiss (1818-65) established the contagiousness of puerperal fever, and
the following year introduced antisepsis into the practice of midwifery.

    William TG Morton (1819-68) and Henry Bigelow (1818-90), independently and unaware
of Long’s work (see 1842), published papers in the USA on the use of ether during surgical
operations. See 1847.

1847    Cholera epidemics in London and elsewhere. Typhus epidemic in Scotland.
Towns Improvement Act (1 0&1 1 Vict.., c.34) consolidated provisions for adoption in
private acts for paving, drainage, cleansing, lighting and general improvement of towns. Similar
acts were passed containing model clauses for the police, water and cemeteries. See l856.

    Poor Law Administration Act (10&1 1 Vict.., c.109) revised and consolidated previous
legislation setting out rules and principles for the administration of the poor laws. The intention
was to ensure more humane practice than that of many boards of guardians, but the new
powers were used sparingly and the enforcement of the principles gradually fell into desuetude.
See 1860.

    Hours of Labour of Young Persons and Females in Factories Act (1 0&1 1 Vict.., c.29), the
Ten Hours Act, reduced the permitted maximum hours of work for women and children to 10
hours per day and 58 hours in any one week. See 1850.

    Corn Laws, which imposed duties on imported corn, repealed (10&11 Vict.., c.1, 2 and 3).

    Select Committee on Medical Registration reported.

    Sir James Simpson introduced chloroform as an anaesthetic. See l858.

    Dr WH Duncan (1805-63) appointed medical officer of health for Liverpool (see 1846). See 1848

    Building started of Edwin Ackroyd’s model industrial community at Copley, near Halifax.
See 1853.

1848    Major cholera epidemic with about 60,000 deaths, about 14,000 in London.
Influenza pandemic; there were about 50,000 deaths in London alone.
Public Health Act (11&12 Vict.., c.63) created a new central department, the General
Board of Health, under a nominated president, and provided for local boards of health to be set
up; in municipal boroughs these were to be the town councils, elsewhere they were to be
special boards elected by the rate payers on the same footing as the election of boards of
guardians. Each board of health was empowered to appoint a surveyor, an inspector of
nuisances, a treasurer, a clerk and an “officer of health” who had to be a legally qualified
medical practitioner. The appointment of the officer of health and his removal was subject to the
approval of the General Board of Health. The act contained numerous sanitary clauses
including the cleansing of sewers, sanitation of houses, supervision of lodging houses and
slaughter- houses, and maintenance of pavements. The General Board had no system and no
powers to enforce effective local action where the clauses of the act were not adopted locally.
This is the first act in which the term “public health” appears. The act did not cover London or
Scotland (see 1849); London operated under the Metropolitan Commission of Sewers Act
(11&12’Act., c.112). See 1851, 1854, 1855and 1858.

    Nuisances Removal and Diseases Prevention Act (11&12 Vict, c.123) legislated in
regard to the removal of nuisances and the prevention of epidemic diseases in places where
the Public Health Act was not in force, and gave power for the Poor Law Commissioners to
compel guardians to execute regulations and directions of the General Board of Health. See
1849.

    Metropolitan Commission of Sewers Act (1 1&12 Vict.., c.1 12) established the
Commission in regard to London except for the City which operated under its own City Sewers
Act (1 1&12 Vict.., c.163).

    Spreading of Contagious or Infectious Disorders among Sheep, Cattle and other Animals
Act (1 1&12 Vict.., c.107) introduced penalties for exposing for sale meat unfit for human
consumption, and gave powers for the destruction of such meat. Regulations to be made by
the Privy Council. See 1866.

    Final Report of the Royal Commission on the Health of the Metropolis.

    Dr (later Sir) John Simon (1816-1904, then lecturer in pathology at St Thomas’s Hospital
Medical School) appointed medical officer of health to the City of London under the City Sewers
Act (see above). See 1855.

     “Lectures on the Diseases of Infancy and Childhood”, by Charles West (1816-98,
physician at St Bartholomew’s Hospital and later the Hospital for Sick Children, London),
published. This was the first treatise on diseases of children to be published in England.

    St John’s House, Blandford Square, London, established by the Church of England for
the training of nurses using London hospitals for practical experience.  Elizabeth Jesser Reid (1789-1866) arranged lectures for women in a house in Bedford Square, London, which in the following year became The Ladies College, and later Bedford College, London University.

    Karl Marx (1818-83) and Friedrich Engels (1820-95) published “The Communist
Manifesto”; and in 1867 the first volume of “Das Kapital” was published.

1849     Cholera epidemic reached its peak in the week ending 15th September, when 3,183
deaths were reported in London.

    Nuisances Removal and Diseases Prevention Act (1 2&1 3 Vict..,c.1 11) extended the
powers of the 1848 Public Health Act (1848, c.63) and the previous act (1848, c. 123) and
brought the state of burial grounds under the supervision of the inspectors of nuisances. See
1855.

    Public Health (Scotland) Bill rejected, in part due to reports from a committee of the
Royal College of Physicians of Edinburgh which expressed doubts upon some of the
measures contained in the English act of 1848. These had not “tended to increase their
expectation of the efficacy of measures, applicable to Scotland, for restraining the diffusion of
epidemics, which may proceed from that source”. See 1867.

    “On the Mode of Communication of Cholera”, by Dr John Snow (1813-58), published. In
this “slender pamphlet”, Snow suggested that water was a major mode of transmitting the
causative agent of cholera. See 1854.

    Foundation of the London Homeopathic Hospital.

    Elizabeth Blackwell (1821-1910) qualified MD at Geneva College, New York State. She
was born in Bristol, England, and emigrated to the USA with her parents in 1832. In 1859 she
returned to England and became the first woman to to be placed on the British medical register.
In 1875 she was appointed professor of gynaecology and obstetrics at the London School of
Medicine for Women. See 1865.

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