The capital city's rich history of disease and medicine.
The little we know of early Londoners' health, we know through their bones. Examination of the skeletons found at Roman burial sites shows that they died as we do, of illness, including cancer, and injury. We know something of their diet: worn teeth indicate a rougher diet, but they were less prone to the tooth decay that softer modern foods cause. Surviving graves of both Roman and medieval periods are more likely to be those of the wealthy, who died later and whose ailments related to richer living, but by the 19th century in the graves of the poor the diseases of industrialisation and high-density living such as rickets and tuberculosis become apparent.
Though situated at the edge of the European continent, sequential invasions of the British Isles and an established place on trade routes have brought disease to London as well as new technologies and commodities. Between the 14th and 17th centuries, outbreaks of bubonic plague occurred in London, culminating in the Great Plague of London, which killed 100 000 Londoners, an estimated 20 per cent of the population, in 1665-6.
London's location at the heart of trade and then Empire, has also had positive benefits. The floating hulks of the seamen's hospital at Greenwich, where British sailors returning to their home country with communicable diseases were quarantined, formed the impetus for the establishment of the London School of Tropical Medicine in 1889, where scientists and medics researched the little-understood illnesses that affected populations under the administration of the British Empire. The Chelsea Physic Garden, established in 1673 by the Society of Apothecaries as a place to cultivate curative herbs also became a site of colonial exchange, the source of tea for Indian plantations and cotton for the Americas.
As the Thames served as both source of water and waste pipe for a growing population, water-borne illnesses have often affected Londoners. In the early 19th century, the Thames became notoriously polluted, and in the 1830s, William Cobbett likened the city itself to a cyst on the face of the country, christening it the 'Great Wen'. Nevertheless, ignorance about the origin of disease persisted, and the 'miasma' theory of illness spread through unhealthy air prevailed until John Snow's investigation of the 1854 Soho cholera outbreak confirmed contaminated water as the culprit. In the 1860s, Joseph Bazalgette's sewers piped the waste of metropolitan London eastwards to be released downstream, creating the Thames Embankment in the process and radically altering London's relationship with the river. Even death was exiled to the suburbs with the establishment in the 1830s of the 'magnificent seven' garden cemeteries of which Highgate became the most notable.
London's first hospital, the Priory Hospital of St Bartholomew of Smithfield was established in 1123, granted a site on the edge of medieval London next to the Smithfield meat market. Early hospitals functioned as charities, supported by the donation of alms. In the early 18th century, five new general hospitals for the burgeoning population of workers and artisans were created, and London's first school of medicine, the London Hospital Medical College was founded in 1785 at one of these, the London Hospital in the East End. Hospitals and other health organisations continued to be managed as private charitable organisations until the 1930s when the London County Council paved the way for the establishment of the National Health Service by taking some of London's health infrastructure, its asylums and poor law hospitals, under its wing.
Today, London continues to innovate in both medical research and treatment: Moorfields Eye Hospital is a world leader in both treatment and clinical research of eye problems. Nevertheless, even at the beginning of the 21st century, health in London is still marked by the difference between rich and poor: average life expectancy in Westminster is nearly seven years longer than in Canning Town, merely eight stops away on the tube.