New models of policing population health had been developed in the eighteenth century, including voluntaristic efforts to improve the environment and the civil administration of quarantines, inoculation, regulation of medical practice and the sale of drugs. This chapter examines a selection of nineteenth-century European states, including France, Sweden and Germany which had already begun to institute population health controls in the eighteenth century. Sweden’s experience of public health reform in the nineteenth century illustrates the resilience of the eighteenth-century concept of medical police, which continued to contribute to the policing of personal hygiene among local communities. France led the development of public hygiene as an academic discipline in the first half of the nineteenth century. The ‘birth of the clinic’ in Paris, following the end of the Napoleonic Wars, was matched by the birth of a public hygiene movement. Radical doctors in both France and the German states in 1848 wanted medicine to play a role in national government.