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A matter of life and death

As a doctor I'm interested in what keeps us alive. My experience travelling with my son through parts of Asia suggested that in Britain we take the inventions and protocols essential for our survival for granted.

Two years ago I wrote about two of the interventions that have meant the difference between living or dying, and quoted the British Medical Journal. The first innovation was established by Edwin Chadwick, who was neither a medical doctor nor a sanitary engineer but a lawyer who wanted to prevent a major cause of poverty - acute infectious diseases that killed male breadwinners.

Chadwick believed that these diseases were caused by. . .poor urban drainage. He developed a comprehensive solution: new technologies (sewers rinsed by water, his main reason for bringing piped water to individual homes) and the legal and administrative structures needed to build these expensive works.

As a result Britain led the world in a "sanitary revolution" in the 19th century.

But do not imagine that the government of the time simply fell into line behind Chadwick's effective ideas. As you no doubt suspected, he had to become a one-man band and publish his report into sanitary conditions at his own expense.

If Chadwick's idea that government should be run along scientific principles - rather than greed and self-interest and ideological poppycock - were applied, we would be living in a rather different country.

Another major medical advance was the discovery of germs and the importance of hygiene. In this crucial development, Joseph Lister was influenced by his father, Joseph Jackson Lister, a Quaker wine merchant who invented the bichromatic microscope (which uses reflected and transmitted light). This itself was an important event in medical history and meant that Lister was alert to the idea of micro-organisms causing disease.

Lister introduced antisepsis to his surgical practice. He was aware that carbolic acid was used to treat sewage, and he concluded that the same microbes that caused wound putrefaction might be killed through use of carbolic acid solutions to dress wounds. He also insisted that instruments and surgeons' hands should be washed with the solution. Mortality in his wards fell as a result of these measures.

A glance at NHS hospitals appears to indicate that standards of hygiene and cleanliness are not as good as they were when I worked in the NHS thirty years ago. The government finds itself unable to reduce MRSA infections (that highly resistant strain of staphylococcus aureus). This, again, is because government is not run on fundamental, reality-based principles but on hot air.

This website/blog celebrates the best of the Brits, but we sometimes find ourselves looking into the past at achievements that have been forgotten. If Lister’s lessons were relearned by everybody that works in hospitals, I have no doubt that hospital-acquired infections, including MRSA, could be drastically reduced. It's an easily tested idea. . .

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