• modern understanding of key diseases
• smallpox
• yellow fever
• cholera
  
• what were the theories before the germ theory of disease was accepted in the 1880s?
• humours--disease is caused by an imbalance in the body
• doctors were educated in universities going back to the middle ages, but theories of treatment were very hard to put on a scientific basis
• disease was punishment from God, or inevitable
  
• miasma theory
• possible approaches to reducing disease
• clean water
• move trash and stagnant water
• improve ventilation of buildings
  
• quarantine
• inoculation
• Snow 1849--polluted well caused cholera
  

• technological fix
• path dependence--once you are on one technological path it is hard to change (also called technological determinism)
  
• cast iron
• steam engine
• storm sewers vs sanitary sewers
• when you provide a water supply then the sewers have to cope with a lot more water
  

Role of government:

• the US was a backwards country (before 1850-1919) and advanced technology was coming from England
  
• Jeremy Bentham: Utilitarian ethics
• Sanitary Act of 1848 in England--the government should act to improve the health of citizens (a radical idea)
• context of the industrial revolution in England