Public Health Measures.

Public health measures are non-medical interventions used to reduce the spread of disease. They include providing public education, conducting case and contact management, closing schools, limiting public gatherings, issuing travel restrictions and screening travellers. From fourteenth century or even more early, societies have made lots of efforts to prevent, contain, cure and eradicate infectious diseases. This is why today we can live in a relative safer world compared with people in history. This page will introduce some famous public health measures including good ones and bad ones, which are focused on plague, smallpox and cholera.

Public Health Measures Gallery

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Skeletons in plague pits
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Lazzaretto of Manoel Island, Malta
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Comparison of smallpox (left) and cowpox (right) inoculations 16 days after administration
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Dr Edward Jenner performing his first vaccination on a boy of age 8.
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Construction of the sewers in 1859 in London
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Thames Embankment under construction in 1865

Skeletons in plague pits
Lazzaretto of Manoel Island, Malta
Comparison of smallpox (left) and cowpox (right) inoculations 16 days after administration
Dr Edward Jenner performing his first vaccination on a boy of age 8.
Construction of the sewers in 1859 in London
Thames Embankment under construction in 1865

For Plague

Public policy for plague was first devised in the northern Italian city-states, in the fourteenth and fifteenth centuries. This is the world's first system of public health. The embryo of the system was established during the Black Death, and then became increasingly sophisticated and comprehensive through the middle of the sixteenth and seventeenth and then the eighteenth centuries. This policy includes:

New Institution
They were originally called health magistrates (nowadays, they are boards of health). They were endowed with extraordinary powers during emergencies that gave them--they combined in their hands a plentitude of legislative, judicial and executive authority in matters that related to public health. By the late sixteenth century, permanent health magistrates had been set.
Compulsory Burial
It included burying dead together into plague pits, burning their personal effects, banning funerals and funeral processions and also banning laying out and the wake.
Control Movement
It was actually the control of the movement of people from plague-infested regions by quarantine. There were squads of soldiers turning people away from city gates and opening fire on those who tried to cross the line. Also, infected people were isolated in lazarettos or their own home, with watchmen outside to arrest or even kill those who tried to escape.
Control Markets
It was to guarantee the supply of food to an afflicted locality, so that people wouldn't die of famine, as well as disease.

For Smallpox

Smallpox, was to lead to a very different but highly effective style of public health; that is, first inoculation and then vaccination, associated with Edward Jenner. Even more spectacularly than plague measures, vaccination ultimately promoted a victory over smallpox, leading in 1980 to its total global eradication.

Inoculation
The major technique for inoculation was that liquid material from a smallpox pustule of a patient selected for having a very mild case was allowed to soak into a thread. The thread was then inserted into a superficial cut, made with the lancet into the arm of the person to be protected, and fastened there for twenty-four hours, hoping the subject would recover from a mild smallpox and obtain immense for a lifetime.
However, it would fail to produce the desired mild infection, but led instead to severe illness and death; and invariably it caused a month or two of immense suffering.
Vaccination
There were three species of the genus of orthopoxviruses: Variola major, Variola minor, and cowpox. The first two are exclusively infectious to human beings, but the third mainly affects cattle. But under the right conditions, cowpox can be transmitted to humans, among whom it induces a mild illness, but it provides a robust crossover immunity to Variola major. Edward Jenner, an English country doctor, used cowpox to make experiments and proved this.
Unlike inoculation, vaccination didn't introduce an infection of smallpox itself, and therefore had no risk of setting off an unintended epidemic. It also had a low risk of serious complications for the individual patient, and no risk at all for the community.

For Cholera

At first, people attempted to control this disease with the plague measures, but it was entirely ineffective. They tried to find a new way to control it. It also led to the sanitary movement, including refitting and sanitary revolution in cities, and even the rebuilding of places like Paris and Naples. But also, some countries adapted concealment during special time to deal with it and casused bad results.

Sanitary Movement
This was pioneered in Britain in the 1830s and '40s, and it was then exported to the continent in North America, assuming particular forms in France and Italy, with the actual rebuilding of cities in accord with sanitary principles. This greate public project included establishment of sewer systems, a whole infrastructure of water mains, of waste removal, street cleansing, improved and less crowded housing, the creation of parks and public spaces.
Concealment
In the summer of 1911, an cholera epidemic was concealed by the Italian authorities. The prime minister of Italy ordered the state police in Italy to deal with a new offense, which was sanitary defeatism. That time was the fiftieth anniversary of Italian unification, and the whole world was descending on Italy. Warning the world that cholera was rampant in Italy at this time, would have had enormous economic repercussions for tourism, a major industry. So this concealment then went forward, and it was orchestrated at the very highest levels. The press, physicians and public health authorities were censored and were threatened.
One of the results of this measurement was cholera spread through many provinces of Italy. It was placing at risk the health of international visitors to Italy, tourists and people who came to see the celebrations of 1911. And one of the truly unfortunate parts of the concealment effects is that it led to thousands of deaths of Italians.