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The Three and Sixpenny Doctor

Health and Disease before 1900

Intensive Urbanisation and Industrialisation

The economic changes brought about in the nineteenth century resulted in increased injuries and disease. Over-crowding, poor working conditions and under-nourishment contributed to the spread of a number of infectious diseases. The worst outbreak of cholera was in 1832, killing 50% of those infected. Other diseases such as typhus, scarlet fever, diphtheria, St Anthony’s Fire (erysipelas), TB and smallpox were also a problem. Specialist fever hospitals, such as the Royal Victoria Hospital and East Pilton (later the Northern General) were built, but were unable to cope with the large number of patients.

Self-help and Insurance Schemes

Care of the sick was regarded as a private duty. Voluntary organisations, including friendly societies like the Ancient Order of Foresters and Gardeners’ or professional/work-related insurance schemes, would pay for the treatment of contributors and their families. But there were many families who could not afford to pay into such schemes and whose access to health care was limited.

Girl (on right) with Rickets, 1920s

(Photo, City of Edinburgh Museums and Galleries Collection)

State Intervention

Through the late 1800s a number of public health acts were passed to control the spread, and improve the treatment of disease. Policies such as improved water, sewage, housing and vaccination were introduced. These procedures were expensive and not compulsory, and so some town councils were often reluctant to introduce them.

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Children in Gorgie, about 1900 (Photo, LMA archive)