Public health and epidemics in the 19th century

1. Board of Health, 1805-1806

In February 1805 the Privy Council established a Board of Health to advise it on action to prevent the spread to Britain of a fever then prevalent in Spain and Gibraltar. The Board members consisted of five fellows of the Royal College of Physicians, one commissioner of HM Customs, one commissioner of the Navy Board and one of the Board of Sick and Hurt. The Board met until August 1806. Records of its activities are in the Privy Council Unbound Papers (PC 1). It produced five reports (PC 1/3637, PC 1/3666). Reports on foreign epidemics made to the Board are in MH 98/1.

2. Board of Health, 1831-1832

Fears of a cholera epidemic led to the creation of another consultative Board of Health in June 1831. Its minutes are in PC 1/101 and HO 31/17. A sub-committee of the Board prepared regulations to prevent the spread of the disease which were issued as Orders in Council and published in the London Gazette of 25 October 1831 (ZJ 1/189). The following month a new Central Board of Health replaced the consultative one. It sat at the Privy Council Office with an advisory committee of the Royal College of Physicians. Nearly 1200 local boards of health were created, constituted by Orders in Council, in addition to those formed on local initiative. Minutes of the Central Board are in PCI/105, with registers of correspondence and letter books in PC 1/93-100 and other miscellaneous papers and correspondence in PC 1/102-4, PC 1/106-14, PC 1/2260-2262, PC 1/4395 and MH 98/1. The Board was dissolved in December 1832 and the local boards disappeared as the epidemic receded. For a further eighteen months the Privy Council Office continued to deal with correspondence about cholera. Surviving records of the local boards should be sought in the appropriate local record office.

3. Poor Law commissioners' enquiries and survey, 1838-1842

Conditions of public health and sanitation were a concern of the Poor Law Commission set up in 1834 and its successor the Poor Law Board established in 1848. Edwin Chadwick, one of the Poor Law Commissioners, organised an investigation into the sanitary condition of the poor in east London. Drs Kay, Arnott and Southwood Smith carried out the work and the results were published in the annual report of the Poor Law Commissioners 1838 (HC 1837-8 xxvii). These enquiries led to a further, more extensive survey, conducted by the Commissioners but published under Chadwick's name as Report on the Sanitary Condition of the Labouring Population 1842. The assistant commissioners were involved in collecting material for this report; some of their original returns survive either among their correspondence (MH 32) or among the Poor Law Union correspondence and papers (MH 12), e.g. MH 32/16 contains William Day's synopsis of reports on housing conditions gathered from answers from relieving officers in N Wales, etc. Correspondence about conditions of labouring population are noted in the registers of the correspondence of the assistant commissioners e.g. in MH 33/2 under Day and Gilbert.

4. Health of Towns Commission, 1843

The Royal Commission on the Health of Towns was appointed in 1843 as a direct result of Chadwick's report. The Commission made a thorough investigation of the sanitary arrangements of 50 English towns. Its minute book is in MH 7/1 and its report was printed for parliament (HC 1844 xvii and 1845 xviii)).

5. General Board of Health, 1848-1858

The recommendations of the Health of Towns Commission led to the passing of the Public Health Act 1848. It established the General Board of Health for five years with three commissioners, later four. In 1854 the Board was reconstituted with a President responsible to parliament. Localities could petition the Board for application of the Act in their areas, that is to form their own local boards of health. Where the average death rate exceeded 23 per 1000 the Board could create local boards on its own initiative.

When a local board was created an inspection of the sanitary state of the area was made. None of the reports of these inspections survive among the Board's correspondence in MH 13. Two isolated individual reports are available among the Privy Council Unbound Papers (PC 1/2665 and PC 1/2667) but this Office contains no discrete collection. Sets of the reports are held at the library of the Department of Health and Social Security (DHSS) and the British Library (from Chadwick's estate), and odd survivals are in some other public libraries. The National Archives holds a copy of the DHSS's set (with some additions) published on microfiche by Harvester Press in PRO 28/125; an index is included in the fiche.

Original petitions for local boards, general correspondence and draft out-letters of the General Board of Health are in MH 13, arranged alphabetically first by urban district and then by rural district. That series also includes six boxes of correspondence and papers on cholera, yellow fever and quarantine for the years 1848-54 (MH 13/245-50). Some other Board correspondence survives in HLG 1 and HLG 46. Minute books of the Board are in MH 5 and MH 6. Instruments and consents to local board schemes are in HLG 19, but no registers have survived. Similar instruments sanctioning borrowing or mortgages by local boards are in HLG 15, with nominal registers in HLG 16. Bill papers relating to public health and local government legislation are in HLG 29. Surviving records of the local boards should be sought in the appropriate local record office.

6. Local Government Act Office

After the abolition of the General Board of Health by the Public Health Act 1858 its functions and staff were transferred in part to the Local Government Act Office, a sub-department of the Home Office, and in part to the Medical Department of the Privy Council.

The Local Government Act Office dealt with correspondence and reports directed to the Home Secretary or its own secretary by local boards of health. Its three engineering inspectors also undertook investigations resulting from the application of the Sanitary Acts of 1866-70, which obliged local authorities to inspect their districts and suppress nuisances. MH 13 contains the resulting reports, and correspondence about reports from these inspectors concerning matters of interpretation of the sanitary legislation is on Home Office registered files (HO 45). Instruments and consents to local authority schemes are in HLG 19; HLG 15 includes similar instruments sanctioning borrowing, with related registers in HLG 16.

7. Privy Council Medical Department

The records of this department have not survived, with the exception of a few stray items in PC 1. Information about the activities of the department may be derived from the annual reports of its Medical Officer, printed for parliament. They include, either in extract or in full, reports of the numerous local enquiries made by the permanent medical inspectorate, thus providing a remarkable picture of the disease pattern and social and industrial conditions of the period. Copies of a few of these reports occur among the early volumes of the Buchanan Papers (MH 113), a series of, mostly printed, reports and memoranda assembled for the use of the Principal Medical Officer to the Local Government Board (LGB). Some personal details about these inspectors may be gleaned from the inspectorate correspondence (MH 32/105, MH 32/106).

8. Rationalisation of authorities

By 1870 there were over 700 authorities working under the public health and local government legislation; there were also poor law and registration authorities operating within their boundaries, but uncoordinated. In small towns and rural areas parish vestries, boards of guardians, highways boards and other bodies all had a hand in public health matters. The report of Royal Sanitary Commission, set up in 1869 to investigate this complicated situation, resulted in further legislation: the Local Government Board Act 1871, which transferred to the Local Government Board the sanitary and public health functions of the Privy Council Medical Department, and two Public Health Acts 1872 and 1875 which established rural and urban sanitary authorities and made compulsory the appointment of medical officers of health to advise them. Later legislation in 1888 set up county councils and enabled them to appoint medical officers of health and in 1894 established urban and rural district councils as health administrations.

9. Local Government Board, 1871

The sanitary department of the Local Government Board took over from the Local Government Act Office responsibility for local government environmental health services. The Public Health Department dealt with the administrative aspects of public health and vaccination functions transferred from the Privy Council Office and Poor Law Board respectively. MH 25 contains the general correspondence of these two departments, with local authority correspondence and papers in MH 12, MH 30 and MH 48. The departmental correspondence (MH 19) includes turn-of-the-century material on specific diseases: cholera in MH 19/227-244; yellow fever in MH 19/244-246; plague in MH 19/244, MH 19/247-275; smallpox in MH 19/276; and quarantine regulations in MH 19/277-80. Notification of infectious diseases, beginning with cholera, was made compulsory by the Public Health Act 1875; MH 23 contains the resulting correspondence between 1877 and 1896.

10. Surveys, 1885-1895

Several public health surveys were undertaken by the LGB Medical Inspectorate towards the end of the nineteenth century: cholera in 1885; a port and riparian survey in 1892; and a general sanitary one in 1893-5. The returns of these investigations are among the local authority correspondence (MH 12); those for 1885 and 1892 in the general series of correspondence for the appropriate urban or rural sanitary authority within a given poor law union and those for 1893-5 in a separate section of sanitary correspondence for the relevant urban or rural district of the union.

11. Foreign epidemics

MH 98 contains correspondence about foreign epidemics, consisting mainly of information from British consular officials, statistics concerning mortality and the distribution of disease, newspaper cuttings and extracts from foreign journals together with some correspondence on related subjects such as ship quarantine. Similar material occurs in MH 19 in volumes dealing with special subjects, usually individual diseases. The Buchanan Papers (MH 113) also contain reports on foreign epidemics. Other correspondence from consular officials will be found among the Foreign Office General Correspondence series, arranged by country. There are also a number of Foreign Office case papers on international sanitary conferences:

Sanitary Conference in Paris, 1851-1853, 1859-1860: FO 97/210-218
Cholera Conference in Constantinople, 1865-1867: FO 78/2005-2008
International Sanitary Convention in Austria, 1874: FO 7/982-983
Venice Sanitary Conference, 1891-1893, 1897: FO 83/1280-1284, FO 83/1573
Dresden Sanitary Conference, 1893: FO 83/1277-1279
Paris Sanitary Conference, 1893-1894: FO 83/1329-1331
Venice Plague Convention, 1898: FO 83/1641
Paris Sanitary Conference 1902-1903 FO 83/2055-2056

Colonial Office original correspondence also contains information about outbreaks of epidemic diseases. Confidential print and Parliamentary Papers (subscription required) are further sources.

12. Further reading

Fraser Brockington, Public health at the Privy Council 1805-6 (London, 1963)

Richard Albert Lewis, Edwin Chadwick and the public health movement 1832-1854 (London, 1952)

Margaret Pelling, Cholera, fever and English medicine 1825-1865 (Oxford, 1978)

Samuel Edward Finer, The life and times of Sir Edwin Chadwick (London, 1952)

Anthony Brundage, England's "Prussian Minister": Edwin Chadwick and the politics of government growth 1832-1854 (Pennsylvania, 1988)

William Farr, 1807-1883: the report of the centenary symposium held at the Royal Society on 29 April 1983 (London, 1985)

Anthony Stephen Wohl, Endangered Lives: public health in Victorian Britain (London, 1983)