Man and His Environment
The history of these earlier steps is full of interest; but I cannot outline it today. There can be no doubt that as Simon[3] put it, referring to Dr. Southwood Smith’s report to the Poor-Law Commissioners in 1838 (“on Some of the Physical Causes of Sickness and Mortality to which the Poor are particularly exposed, and which are capable of removal by Sanitary Regulations”)
the commencement of State interference on behalf of the health of the labouring classes may be said to date from its publication and to have been in a very important degree determined by its facts and arguments.
That the first principles of causation were beginning to be appreciated is shown in the following extract from Queen Victoria’s speech in opening Parliament in 1849. In this speech she referred to the ravages of cholera which it had pleased Almighty God to arrest, and added:
Her Majesty is persuaded that we shall best evince our gratitude by vigilant precautions against the more obvious causes of sickness, and an enlightened consideration for those who are most exposed to its attacks.
Note that these words and the early attempts at public health legislation, culminating in our great sanitary code, the Public Health Act, 1875, incorporated the tripod on which enlightened public health administration must always be supported, viz.,
(1) attack on the causes of sickness,
(2) satisfactory treatment of the sick, and
(3) satisfactory care for the poor.
I might properly add
(4) attack on the causes of poverty,
for it is perhaps the chief merit of the great work of Edwin Chadwick that, in the light of reports on local surveys made by Kay, Southwood Smith, and others, he was convinced and was able to convince Parliament that a very large share of the total destitution then existing was due to the conditions under which the people lived, and the disease generated in these conditions.