Academic journal article Urban History Review

Public Health and Social Justice in the Age of Chadwick, Britain 1800-1854

Academic journal article Urban History Review

Public Health and Social Justice in the Age of Chadwick, Britain 1800-1854

Article excerpt

Hamlin, Christopher.

Nineteenth-century urban historians are familiar with campaigns to clean up unsanitary cities through the provision of clean water and the efficient removal of human and industrial waste. This public health movement, as it is usually called, took its origins in early Victorian Britain under the leadership of the bureaucrat Edwin Chadwick, and by the end of the century his program for urban renewal had been largely adopted in England and abroad. Analysis of the differential implementation of sanitary reform is a staple of Victorian urban history, yet according to the medical historian Christopher Hamlin the content of Chadwick's program itself has never been subject to proper scrutiny. Historians have accepted Chadwick's paradigm for public health as though it was the only possible rational solution to the crisis of urbanization. In this important book, Hamlin subjects Chadwick's model of public health to critical reappraisal. Chadwick, Hamlin argues, did not discover the sanitary solution to excessive urban death and disease. Rather, he actively constructed a narrow, technocratic, conservative version of public health in contrast to a rival social medicine with far more reformist potential.

The first two chapters outline the state of social medicine before Chadwick. Here Hamlin brilliantly recovers a lost tradition that was especially prominent among Poor Law medical practitioners and Scottish physicians. Medical men had realized well before Chadwick that filthy circumstances and water predisposed the poor to ill health, yet their theory of disease admitted a much greater range of potentially destabilizing influences on health than did Chadwick's. They were especially concerned with work and wages, and with the medical consequences of low pay and brutal working conditions.

This early social medicine was, however, never institutionalized in Britain, and one of Hamlin's goals is to explain that failure. Hamlin devotes five chapters -- more than half of the book -- to the years 1833 to 1845 during which Chadwick created the sanitary version of public health. …

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