ABSTRACT
Risk of ill health certainly underlay early public health measures in Britain. The role of contagion in the spread of disease had been known since the second Bubonic Plague of 166042 and had led to quarantine regulations in Venice as early as the 14th century. As the Industrial Revolution and the various Enclosure Acts created increasing urban poor populations, the risk of epidemics grew. Edwin Chadwick and other public health reformers championed the need for national action to improve sanitation so as to protect the urban bourgeoisie from disease rooted in the poor.43 Miasmatism, popular during the 18th and 19th centuries, saw disease as resulting from marshes and swamps producing airborne substances that produce fever, and although the theory was wrong, it nevertheless supported measures which had a positive effect on the health of the population.44 Clean water, efficient sewerage disposal and drainage had a far more significant impact on the nation’s health than clinical interventions45 and these public health measures reached their peak in the mid-19th century. Vaccination and inoculation programmes were also used in the early 20th century to address the problem of epidemics amongst the poor. It has been argued, however, that this is more an example of preventative medicine treating the individual than a measure properly described as public health, even where it is sponsored by the State.46
