Page 147

Geneeskundeboek-Opmaak Binnenwerk-ENG.indd

Left above: Ward in the Hospital Calvariënberg about 1900. | RHCL, GAM F14958 Left below: Stethoscope of Laennec 1819. | Archive NIV Right: Title page of the book by René Théophile Hyacinthe Laennec (1781-1826) in which he published the invention of the stethoscope (1819) and the clinical application thereof. | Archive NIV 145 All these developments had a positive effect on individual patients’ chances of recovery. Nevertheless, morbidity and mortality figures, when available, showed hardly any change. The English lawyer and journalist, Edwin Chadwick (1800-1890), was one of the first to suggest that living conditions, hygiene and sanitary facilities might be of far greater importance. After a great deal of criticism and disbelief, this idea gained worldwide acceptance, also among Dutch doctors, particularly those who worked in the slums of the large cities. For they were daily confronted with the miserable living and working conditions of the poor and therefore realised that poor public sanitation had to contribute to disease and mortality one way or the other. This insight was reinforced by the cholera epidemics in those days. The general view, however, remained that many diseases were caused by fumes evaporating from rotting substances. Bacteria were unknown. These medical workers, named hygienists, set up a national network of morbidity and mortality registries that enabled them to identify regional differences and follow those over time. In this way, the association of common diseases with public sanitation could be examined. The provincial Committees In 1865, as a result of Thorbecke’s law on Government of Medical Investigation and Surveillance had been obliged to Inspection of Medicine, the Committees of Medical Inspection publish annual reports on prevailing diseases, but these reports and Surveillance (Commissies voor Geneeskundig Onderzoek were not used. The hygienists on the other hand published all en Toevoorzicht were abolished. They were replaced by their information thereby exerting political pressure to enforce inspectors charged with surveillance of the condition of public changes. The Maastricht physician Dr F.E. Fouquet (1822-1908) health and developing recommendations for improvement. was one of those hygienists. As a doctor of the poor he worked in They reported to the minister, but they also advised municipal Sint Mathias parish, a working class neighbourhood between the councils. The latter were autonomous, however, and did not Bassin and the Kleine Gracht for some 25 years (1854-1880). take much notice of the advice. Also many municipalities had Many labourers of the factories of Petrus Regout lived there. changed the old local Committee of Medical Inspection into a Fouquet became convinced that the abominable living and municipal health committee, which also advised the municipal working conditions of the labourers were the cause of their poor council. Occasionally, this was counterproductive. health.


Geneeskundeboek-Opmaak Binnenwerk-ENG.indd
To see the actual publication please follow the link above