Our Victorian ancestors were obsessed with public health. But then, few things concentrate the mind quite as much as the prospect of regular and deadly outbreaks of contagious disease. And unlike the health scares of the 1990s, those of the 1830s and 1840s were particularly real in nature.
The Victorian Web, based at Brown University in the US, notes how, after a period of calm in the early years of the century, Britain was hit by eight serious bouts of influenza in 16 years, suffered the return of smallpox after the initial success of vaccination, and endured epidemics of typhus, typhoid and cholera.
Small wonder, then, that the era inspired the likes of Edwin Chadwick to take a professional interest, saw the appointment of the first medical officers of health, and spawned a profusion of societies in which the political classes could discuss the threat posed by the Great Unwashed.
Efforts to rationalise these bodies were to little avail, and many went to the wall as public interest waned. Among the survivors, the Royal Sanitary Association of Scotland (founded 1875) and the Scottish Institute of Environmental Health (1891) became the Royal Environmental Health Institute of Scotland in 1983, while the Royal Institute of Public Health and Hygiene and the Society of Public Health, which first discussed merger in 1890, finally merged last October.
After Chadwick's 1842 report on sanitary conditions, public health gradually became a state responsibility, and, of course, today's health authorities take a lead role. Indeed, many Public health directors' annual reports can now be found online. More can be found in the online library of the West Midlands NHS regional network, Reginet, which also includes some of the protocols and guidelines which make up public health work today. For what happens next, keep watching the Department of Health for that green paper.