the Public Health Act

 

In the mid-XIXth Century, the British government took measures to promote public health in the main cities. Because of the Industrial revolution, population from the country-sides moved to the prospering cities where the industrial activities were concentrated. At this time, cities were expending and the question of public health became more important than ever: the new-comers who worked in the factories during the day, lived in rudimentary places after work, and in the humble neighborhoods, overpopulation and epidemics were current.

To remedy at the situation, the government passed in 1848 the Public Health Act, which provided the creation of a General Board of Health and Local Boards in the urban areas. The same year, the doctor John Simon was appointed Medical Officer of Health for the City of London; he was especially in charge of the maintenance of the sewers, which were very important to ensure the wholesomeness of cities. He also was in charge of making annual reports on the evolution of the living conditions of the citizens ; this text, the City Medical Report of 1849 is one of those reports. John Simon made many proposals in order to improve the living conditions of the poor, for example solidify the concept of state scientific research, strengthen the existing public vaccination system and supervise members of the medical profession.

The text evokes the situation in England at this time, and how the public opinion explains it.

 

                 It is necessary to contextualize the text to understand it. In the XIXth century, living conditions of the poor and sanitary reforms became one of the greatest debates. In the country and especially in the cities, it occurred serious sanitary issues which were at the origin of murderous epidemics, as, for example the epidemic of cholera in 1849. In this report, the author starts with a long description of the miserable living conditions of the poor: they lived in houses containing “sanitary evils” (l.9), and he makes a list of them. Among them, we can notice the absence of hygiene (houses without lavatory, waterless and unventilated) which means that the diseases could proliferate. The author also evocates the overpopulation, which is a threat to wholesomeness: people are too numerous in each house and live in dirt, so they develope diseases more easily.

                The historical context explains these sanitary issues in England in the XIXth century. The main cause is the industrial revolution. It provoked the rural exodus which leaded to the rally of the population of poor farmers in city districts in which they lived in rudimentary housings. There was soon an overpopulation in these districts and they were degraded. Moreover, the new industries needed workforce but the transports (to join the country-side to the city) were not developed enough, so, either the industries offers rudimentary housings, or people settled by their own near to the production centers.

                J. Simon wrote in the middle of the XIXth Century; at this time, in Britain, the sanitary sphere is closely connected to the moral sphere. It is a characteristic of the Victorian values, in force at this time. The aristocrats, who paid a sharp attention to hygiene, considered that the social gap between the upper and lower class was symbolized by the difference of hygiene: the inferiority of the poor was attested by their dirtiness, while the superiority of the rich was shown by their perfect hygiene. The social distinction between the two classes drove to a moral distinction. Poor were presented as creatures without any moral sense ; according to the upper class, they had no shame and lived in a scandalous lack of privacy (exactly like cattle) : “Men and women, boys and girls, in scores of each, using jointly one single common privy ; grown persons of both sexes sleeping in common with their married parents” (l. 16-17).

                It was in this context that the author wrote his report. Dr J.Simon, as a doctor, belonged to the upper class. In the first part of the text, he seems to stick with the Victorian values. In the second paragraph (from l. 9 to l. 28) he confesses that these values are based on truth, he does not deny the situation, because he had been able to observe it by his own. He shared the upper class’ ideas, and according to him, the life conditions of the poor got worse and their morale values too : « to whom personal cleaness is utterly unknown ; smarms by whom delicacy and decency in their social relations are quite unconceived » (l. 14 to 16)

                J. Simon bring many testimonies of the dreadful living condition of the poor in this document, he employs frequently the pronoun “I” and insists on the fact that he actually is a direct witness of the poor's behavior (l 16 to 20). He notes that those people became accustomed to this way of life, and their degrading condition doesn't trouble them. He considers the possiblity that the workers are too deeply acustomed to their living conditions to change them easely : “[they] have been led, perhaps to consider themselvses as inseparable from poverty” (. 28-29). Government took measures to help the poor, but J. Simon observe that they are useless : he write about the “inefficiency of measures designed for their advantage” (l. 2-3) ; it seems that the state does try to take care of the poor, but they don't cooparate, which is the explaination of the inefficency of the government's help. Because they never learn to use them, the workers can't use correctely the amenities intented for improving their living conditions, such as the water-closet ; they don't understand the fonction of the different items, and “apply indefferently [one of them] to the purposes of each other, or one the purpose of all” (l. 6-7).

                According to J. Simon, these dreadful conditions seem to be exclusively poor's fault. He sais : “It is true that, among theses classes there are swarms of men and women, who have yet to learn that human beings should dwell differently from cattle” (l. 14-15) ; for him, the workers are barley human beings, their behavior is more similar to animals (cattle), than to civilized peopole. J. Simon is from the upper class, and he believes in the victorian hackneyed expressions on the lower classes, which are suppose to be made of individuals stupid, filthy, and whithout any moral considerations. We perceive that he looks with condescension and even with scorn on the lower class : according to him, their habits are “filthy”, “improvident”, “dishonest”. But he also concedes that poor are not the only to blame ; certainly, government tried to improve their living condition by offering some sanitary equipements, but the best way would be to teach them to use them properly, and above all, to inculcate some morality to them. He asks rethorical questions, such as “after their long habituations to such influences (...) the physical debasement of their abode ?” (l. 28 to 30) to show the tragical situation of the society, which considers hygien as a priority, but doesen't take the appropriate measures to guarante it.

                It seems that the only efficient way to help the poor would be to educate them and transmit to them the moral values of the upper class. J. Simon proposes to “convert” them to morality, which will lead to improve their behavior, and logically, their living conditions, because the dirt will became intolerable for them (l. 23-27). Simon points that the poor are “whom the heart of sociey often appears to discard” (l. 40-41) ; it's an implicte critisizm of the rich's desinterest about poor, which has lead to this situation. By taking care of the poor, the rich would reduce the gap separating the two classes and collateraly, they would protect social order and civilisation. The poor behavior is inconceivable by the aristocrats higly normative moral standarts of this time, and represents a real threat upon civilisation, because it is a “manner in wich a people may relapse into the habits of savage life” (l. 21).

                This J. Simon text reflects the concerns of the doctors of this time. At XIXth century, many of them denounce the weakness of the sanitary systems in the european cities which leads to epidemics, but they also denounce the dreadful poverty in which the workers live. J. Simon is a scientist, but he concerns about the quality of the style in his reports, he aims to warn the authorities of the gravity of the social and moral context of the lower classes, to convince them take the right decisions to help the poor. For instance, he uses repetitions “who can wonder (...)” and rethorical questions in a bid to insist on the poor's distress and to make the reader feel responsable for the poor's situation and to provoke his sympathy for the cause.

                The author did not write a neutral report, he did not just explain what happens, but in his text, he tries to understand the situation, gives his opinion and above all, offers solutions directly from his observations. The Simon’s report has a historical dimension because we find in the text the Victorian values of the time, and the situation in the English cities in the XIXth century. It is a particular report also because it is written in a certain style, the author worked on the writing in order to convince the reader. Though John Simon is a doctor, he is not only preoccupied by the sanitary issues but he also cares about deterioration of the poor’s moral values which are the result of their dreadful living conditions. He is not a simple doctor, he has a scientific method (he observes the living conditions of the poor, he tries to find their causes and searches to find a way to improve them), but he also have moral convictions and passes moral judgment on the workers social behavior.