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Edwin Chadwick’s wideranging, amazing achievements by the age of 53

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EDWIN CHADWICK.

Source: “Edwin Chadwick.” Eliza Cook’s Journal, no. 223, 6 Aug. 1853, pp. 229+  [Relevant extract from journal]

EDWIN CHADWICK has not yet been done ordinary justice to by his contemporaries. He has been one of the most indefatigable and successful workers of this age, and yet the world knows comparatively little of him. Though he has, more than any other single man, influenced the legislation of his time, and given a powerful impetus to beneficial legislation for all time to come, we hear less of him than we do of many a fifth-rate parliamentary babbler. Mr. Horne has written a Spirit of the Age, but Edwin Chadwick has no place among the representative men there delineated; and another book, called Men of the Time, has been published, in which not a word is said of Edwin Chadwick, although Chaplin the carrier, and Soulouque the black Emperor of Hayti, are not omitted.

Whether Edwin Chadwick be entitled, or not, to a place among the men of the time, whether he is, or is not, a man who has largely influenced the spirit of the age, let the following brief sketch of his works and career bear witness.

We do not know much about Edwin Chadwick’s birth or ancestry: that is a matter of no consequence. We know, however, that he was born near Manchester, and belongs to a Lancashire family. He received his education chiefly in London, and having chosen the law for his profession, he was enrolled a student of the Inner Temple in his twenty-sixth year. There he “ate his way,” as the saying goes, to the Bar maintaining himself, as Lord Campbell at one time in his life did, by reporting and writing for the daily press. He was not a man of brilliant powers, or of any extraordinary amount of learning. But he was a most sagacious and persevering man, and was ready to confront any amount of labour in prosecuting an attainable object, no matter how remote its attainment might at first sight appear.

At an early period in his career, Edwin Chadwick became possessed of an idea. And it is a great thing to be thoroughly possessed by an idea, provided its aim and end be beneficent. It gives a colour and a bias to the whole of a man’s life. The idea was not a new one; but being now taken up by an earnest, energetic, and hardworking man, there was hope for the practical working out of this idea in the actual life of humanity. The idea was neither more nor less than the Sanitary Idea the germ of the sanitary movement.

We must now briefly state how he worked his way to the practical realization of his idea, in the sanitary movement. It appears that Mr. Morgan, the Government actuary, having been examined before a Parliamentary committee as to the soundness of the Government annuity tables, stated that, though the circumstances of the middle classes had improved, their “expectation of life” had not lengthened. This being diametrically opposed to our student’s idea, he forthwith set to work to demonstrate the fallacy of the Government actuary’s opinion. He laid aside, for a time, the dreary law papers on which he had been engaged, and entered upon an equally dreary course, of reading and sifting of statistical documents, blue hooks, life-tables, and population-tables. His practice of sifting evidence for the attorneys in private cases doubtless helped him in this investigation. He bored his way through the cumbrous pile, working his way to the light, and bringing an accumulation of facts from the most unlooked-for quarters, to illustrate his idea and elucidate his master-thought. The result was published in an able article which appeared in the Westminster Review for April 1828. He there demonstrated, by an extraordinary array of facts and arguments, that the circumstances which surround human beings must have an influence upon their health; that health must improve with an improvement of these circumstances; that many of these circumstances which were unfavourable to the healthy lives of men were under man’s control, and capable of being removed; that the practice of vaccination, the diminution of the ancestral vice of hard drinking, the increase of habits of cleanliness, the improvements in medical science, and the better construction of streets and houses, must, according to all medical and popular experience, have contributed, a priori, to lengthen life; and these he proved by a citation of facts from numerous authentic sources. In short, Mr. Morgan was wrong. The “expectancy of life,” as is now universally admitted, has improved and is rapidly improving; but it was never so thoroughly demonstrated until Edwin Chadwick undertook the discussion and proof of the entire question.

The article in the Westminster attracted the notice of Lord Melbourne, who had a remarkable tact for discovering the qualities of men; and he determined to enlist Mr. Chadwick in the public service. Though no “eloquent” writer, Mr. Chadwick’s pen thus carved out for himself a highly useful, if not a brilliant career in life. Let no one say that the Pen has lost its power in these days!

In like manner, another article, which Mr. Chadwick published in the London Review, in 1829, on Preventive Police, was read by Jeremy Bentham, then in his 82nd year, who so much admired it, that he craved an introduction to the writer. The consequence was, the formation of a friendship that lasted without interruption till the peripatetic philosopher’s death, in 1832. Mr. Bentham wished to engage his young friend entirely in aiding him in the preparation of his Administrative Code, and offered to place him in independent circumstances if he would devote himself exclusively to the advancement of his works. The offer was, however, declined, Mr. Chadwick probably foreseeing that the inheritance of the old Jurist’s principles might hinder his freedom in life; and, with a manly independence, he doubtless felt desirous of carving out for himself his own true career.

Mr. Chadwick completed his law studies, and was called to the Bar in November 1830, and he was preparing for practice in Common Law, occasionally contributing articles to the Westminster, when he was (in 1832) appointed a commissioner, in conjunction with Dr. Southwood Smith and Mr. Tooke, to investigate the question of Factory Labour, which Lord Ashley and Mr. Sadler were at that time strongly pressing on public attention. The sanitary idea again found opportunity for expression ill the report of the commission, which referred to “defective drainage, ventilation, water supply,” and the like, as causes of disease, acting, concurrently with excessive toil, to depress the health and shorten the lives of the factory population.

In the same year (1832), an important Commission of Inquiry was appointed by Lord Grey’s Government, in reference to the operation of the Poor Laws in England and Wales. Mr. Chadwick was appointed one of the assistant commissioners, for the purpose of taking evidence on the subject; and the districts of London and Berkshire were allotted to him. His report, which was published in the following year, is a model of what a report should be. It is full of information, admirably classified and arranged, and so racy, by virtue of the facts brought to light, and the care taken to preserve the very words of the witnesses as they were spoken, that the report. may be read with interest by even the most inveterate enemy of blue-books.

Mr. Chadwick showed himself so thoroughly master of the entire subject his suggestions were so full of practical value, that he was, shortly after the publication of the report, advanced from the post of assistant commissioner to that of a chief commissioner: and he largely shared, with Mr. Senior, in the labours and honours of the commissioners’ report submitted to the House of Commons in 1834, and also in the famous Poor Law Amendment Act passed in August of the same year, in which the recommendations of the commissioners were substantially adopted and formalized.

One may venture to say now, without fear of being contradicted, that that law is one of the most valuable that has been placed on the statute-book in modern times. And yet no law was more unpopular than this was, for years after it was enacted. But Mr. Chadwick never ceased to have perfect faith in the soundness of the principles on which it was based, and he was indefatigable in defending and establishing it. He is a man who has never failed in the courage needful to enable him to do the right thing, even though it be the unpopular thing. It has been well said, that “to become popular is an easy thing; but to do unpopular justice, that requires a MAN.” And Edwin Chadwick was that man.

While burrowing amidst the voluminous evidence on the Poor Laws, he never lost sight of his sanitary idea. The reports were strongly impressed with it; and not less than one-fourth of the then existing pauperism was traced to preventible causes of disease. Mr. Chadwick’s minute investigations into the condition of the labouring population, and of the poor generally, gave him a thorough acquaintance with the physical evils that were preying on the community, carrying them prematurely out of existence by fevers, consumption, and cholera; and the sanitary idea took firmer possession of his mind than ever.

One day, in 1838, when engaged in his then official vocation of Secretary to the Poor Law Commission, “an officer of the Whitechapel Union entered hastily the boardroom of the Poor Law Commission, and, with a troubled countenance, informed the secretary that a terrible fever had broken out around a stagnant pool in Whitechapel; that the people were dying by scores; and that the extreme malignity of the cases gave reason to apprehend that they were allied to Asiatic cholera. On hearing this the Board, at our sanitary reformer’s instance, immediately appointed Drs. Arnott, Kay, and Southwood Smith, to investigate the causes of this alarming mortality, and generally to report on the sanitary condition of London. Drs. Arnott and Kay sent in a joint report, and Dr. Smith a separate supplemental one; in which, amongst other things, the pernicious effects of the foul water sold in London were ably set forth. These reports were circulated to the extent of 4,000 or 5,000 copies.”[1]

This inquiry ripened at length into the sanitary inquiry, into which Mr. Chadwick threw his prodigious industry and energy. In the mean time he had been engaged as a member of the Commission of Inquiry, “as to the best means of establishing an efficient constabulary force in England and Wales;” the evidence taken in which inquiry Mr. Chadwick embodied in a report as interesting as a novel of Dickens, and affording the most curious insight into the mode of living, the customs, and habits of the lowest classes of the population. When this question had been dismissed, Mr. Chadwick proceeded to devote himself almost exclusively to the great work of his life the sanitary movement. The Bishop of London, in 1889, moved in the Lords, that the inquiry which had been made at Mr. Chadwick’s instance by Drs. Southwood Smith, Amott, and Kay, into the sanitary state of the metropolis, should be extended to the whole population, city, rural, and manufacturing, of England and Wales. Some residents in Edinburgh also petitioned that Scotland might be included; and accordingly, in August 1839, Lord John Russell addressed a letter to the Poor Law Board, authorizing them by Royal Command to extend to the whole of Great Britain the inquiry into preventible disease which had already been gone through with regard to the metropolis. On Mr. Chadwick devolved the onerous task of setting on foot and superintending the inquiry throughout, of sifting evidence, and of afterwards classifying and condensing the information for the purposes of publication.

The first Report on the Health of Towns was ready for publication in 1842; and its preparation was altogether the work of Mr. Chadwick. It ought to have appeared as the Official Report of the Poor Law Board; but as the commissioners (some of whom were at variance with Mr. Chadwick with respect to the administration of the New Poor Law) refused to assume the responsibility of a document which contained much that must necessarily offend many influential public bodies, Mr. Chadwick took the responsibility on himself, and it was published as his report which, indeed, it was, and accepted from him as such by the commissioners.

The amount of dry, hard work encountered by Mr. Chadwick in the preparation of this and his other reports, can scarcely be estimated, except by those who know something of the labour involved in extracting from masses of evidence, written and printed, sent in from all parts of the empire, only the most striking results bearing on the question in hand which are worthy of being embodied in the summary report of the inquiry. The mountains of paper which Mr. Chadwick has thus bored through in his lifetime are immense; and could they now be presented before him in one pile, they would appal even his stout heart!

The sensation excited throughout the country by the publication of Mr. Chadwick’s Sanitary Report, was immense. Such a revelation of the horrors lying concealed beneath the fair surface of our modern Christian civilization had never been made before. But Mr. Chadwick had no idea of exciting a sensation merely; he had an object in view, which he persistently pursued. The report was nothing, unless followed by legislative enactments, which, indeed, shortly followed. A sanitary party was indeed formed; and the ministers for the time being, of both sides in politics, were its influential leaders, giving practical effect. to the sanitary idea.

Mr. Chadwick followed up this report in the following year by another elaborate report on the practice of interment of towns, a work which extended and enforced the views of Mr. Walker on this subject.

A Sanitary Commission was appointed in 1844, to entertain the whole question in its practical bearings. The Commission published two reports, with a view to legislation; but the Free Trade struggle interfered, and little was done for several years. Meanwhile our sanitary reformer was occupied as a commissioner in inquiring into the condition of the metropolis. This Commission published three reports, in which the defective drainage sewerage and water-supply of London were discussed in detail; but as yet, these recommendations have had little effect. Municipal abuses of all kinds, remedied everywhere else, generally find the last strongholds in the metropolis. While all other Corporations are reformed, that of London prides itself on exemption front the law of progress!

We will not venture to describe the character of Mr. Chadwick’s numerous valuable reports; but we cannot omit merely to mention his report (published in 1845) on the Drainage, Paving, Cleansing, and Water-supply of Towns, one of the ablest state papers ever issued from a Government office.

The sanitary idea had its triumph at length in the enactment of the Public Health Act of 1848, and in the appointment of a General Board of Health (of which Mr. Chadwick is a member) to superintend its administration. Numerous supplemental measures have since been enacted, with a view to carrying into practical effect the sanitary principles enunciated by Mr. Chadwick and adopted by the Board. They are also engaged in publishing reports, from time to time, full of valuable information: for instance, in reference to the application of sewerage water to agricultural purposes; on Epidemic Cholera; on Quarantine; on Drainage; on Public Lodging Houses; and such like. The sanitary movement, in short, is a “great fact;” and that it is so, we have mainly to thank Edwin Chadwick, the missionary of the Sanitary Idea.

Indeed, we do not know a more striking instance than that presented by this gentleman’s career, of the large amount of good which a man strongly possessed by a beneficent idea can accomplish, provided he have only the force of purpose and perseverance to follow it up. Mr. Chadwick also furnishes an illustration of this truth that a true man, of high and original powers, works for the service of humanity, and not for the honours which it has to bestow. He is not an actual legislator, and yet he has been the mover of more wise measures than any legislator that can be named. He has possessed the legislature with his leading Idea; and he has created a public opinion out of doors in favour of sanitary reform which will not let them lag, even if they would. Take him in all, Edwin Chadwick is one of the most useful practical men living; a leading man of the time, and a veritable embodiment of the spirit of Ike age. If he be not esteemed in future times as a Clarkson or a Howard, it will not be because he has not deserved this. He will, at all events, be regarded for many generations to come as one of the best practical benefactors of his kind.

[1] Times, December 28,1851.

 

 

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Extract from the Eighth Report of the Medical Officer of the Privy Council, 1865 (John Simon)

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Extract from the Eighth Report of the Medical Officer of the Privy Council, 1865

I have dwelt on the above qualifications in order that I may not be misunderstood in the remarks which I am about to make, doubtless in the contagionistic point of view, on the foreign diseases which came under consideration in 1865. Of these, for my present purpose, cholera is infinitely the most important. Cerebro-spinal meningitis, if diffusible by human intercourse, is not so in a high degree. Yellow fever (apart from other considerations concerning it, to which I shall hereafter advert) may at present be assumed to have little or no tendency to spread in this country. But with cholera the case is different. Not disregarding the qualifications which I began by setting forth: not asserting that the mere uniform influence of contagion would account for the several fitful spreadings of cholera from the East; not ignoring that the power of the cholera-contagium in our climate varies almost infinitely according to local circumstances, and specially according to those circumstances which regulate the distribution of typhoid fever: I yet, for public health purposes, deem it quite essential to insist on the evidence which is now accumulated in all the archives of European Medicine, attesting the contagiousness of cholera.

The doctrine on this subject which in my opinion deserves, in the present state of knowledge, to be accepted as practically certain—sufficiently certain, I mean, to be made the basis for precautionary measures, may be stated in the following propositions:—that, when cholera is epidemic in any place, persons who are suffering from the epidemic influence, though perhaps with only the slightest degree of diarrhoea, may, if they migrate, be the means of conveying to other places an infection of indefinite severity; that the quality of infectiveness belongs particularly, if not exclusively, to the matters which the patient discharges, by purging and vomiting, from his intestinal canal; that these matters are comparatively non-infective at the moment when they are discharged, but subsequently, while undergoing decomposition, acquire their maximum of infective power; that choleraic discharges, if cast away without previous disinfection, impart their own infective quality to the excremental matters with which they mingle, in drains or cesspools or wherever else  they flow or soak, and to the effluvia which those matters evolve; that if the cholera-contagium, by leakage or soakage from drains, or cesspools, or otherwise, gets access, even in small quantity, to wells or other sources of drinking-water, it infects in the most dangerous manner very large volumes of the fluid; that in the above-described ways even a single patient with slight choleraic diarrhoea may exert a powerful infective influence on masses of population among whom perhaps his presence is unsuspected; that things, such as bedding and clothing, which have been imbued with choleraic discharges, and not afterwards fully disinfected, may long retain their infectious properties, and be the means of exciting choleraic outbreaks wherever they are sent for washing or other purposes.

The precautions, generally, which may be taken against contagious diseases are of two kinds:—first, if possible, to prevent the entrance of the contagion;—secondly, if the contagion be present, to annihilate as far as possible the circumstances which favour its spread.[1] And thus, as regards cholera, a first and incalculably important question to be answered by those who have to care for the public health of a country, is the question `whether, by any measures of quarantine, they can provide that all contagion of the disease shall be kept outside the limits of their land.

Subject to one qualification which is not an important one for the present argument, it may, I think, be accepted as certain that quarantine, conducted with extreme rigour, and with the precision of a chemical experiment, will keep cholera out of any part of Europe in which the extremely difficult conditions can be absolutely fulfilled[2] and thus, if I speak to the dry question of medical practice, I have no hesitation in saying that England ought to resist cholera by quarantine. On the other hand, though I cannot pretend to discuss with any kind of authority the non-medical aspects of the question, it would be mere pedantry for me to ignore that facts which are of common notoriety, and considerations which are of common sense, conflict with that medical conclusion. A quarantine which is ineffective is a mere irrational derangement of commerce; and a quarantine, of the kind which ensures success, is more easily imagined than realised. Only in proportion as a community lives apart from the great highways and emporia of commerce, or is ready and able to treat its commerce as a subordinate political interest, only in such proportion can quarantine be made effectual for protecting it. In proportion as these circumstances are reversed, it becomes impossible to reduce to practice the paper plausibilities of quarantine. The conditions which have to be fulfilled are conditions of national seclusion; and the fulfilment of such conditions by England would involve fundamental changes in the most established habits of the country.

In order to illustrate this view, the medical postulates of quarantine deserve to be considered in detail. Quarantine, purporting to be effectual, cannot rest satisfied with excluding from entry such persons as are obviously sick, but, indispensably for its purpose, must also refuse to admit the healthy, till they shall have passed in perfectly non-infectious circumstances, at least as many days of probation as the disease can have days of incubation or latency;—this condition often involving as its consequence that, if one case of disease arise among a number. of persons in quarantine, the whole number of apparently-healthy must recommence their period of probation, and this perhaps again and again. Now, setting aside, as not essential to quarantine, the cruelties which its mal-administration involves, and which in practice are almost identified with its exercise: criticising only the conditions which quarantine, if it is to be effective, must involve: and, for the moment, not even counting as an objection the cost of that gigantic establishment which has to be permanently maintained in order to meet occasional exigencies: I here insist only upon the restrictions.[3] Considering what they, when really carried into effect, must involve—what inconvenience to persons, what interruption to commerce, and on how vast a scale, and for what indefinite duration of time, no one can expect, in regard of great trading communities, that governments, if they go so far as to enact, will have much success in enforcing, quarantine. Against the efficiency of it, when enacted, there operate some of the strongest of all law-breaking influences; on the one hand, instincts of contempt for the narrow self-protectiveness which it represents, and, on the other, those eager commercial interests which now mainly govern the world. The latter, in proportion as they are affected, elude the restrictions which would embarrass them. Contraband of quarantine, like ordinary smuggling, is developed as soon as the inducements for it are considerable. And thus, practically speaking, where great commercial countries are concerned, it can scarcely be dreamt that quarantine-restrictions will be anything better than elaborate illustrations of leakiness.

In respect of England, moreover, there are other facts to be stated. In 1832-3, when some sort of quarantine against cholera was adopted here, the results gave no encouragement to a repetition. Then followed the erroneous belief (which subsequent better knowledge has corrected) that the spread of cholera is unaffected by human intercourse. Under these and other influences the thought of quarantine in England became more and more obsolete, and the possibility of enforcing it, if ever so much desired, fell more and more towards nothingness. Probably there was the practical conviction that, against any contagious disease current on the continent of Europe, quarantine, of the utmost strictness which England could hope to attain, would not give results worth the sacrifice. I daresay that quarantine in England was never otherwise than very lax. And at all events for many years past it has, in every medical sense, been abolished. Also with its virtual extinction, the establishment for giving it effect has declined. As successive governments advanced further and further in relinquishing what probably at its best was only a sham of quarantine, corresponding reductions of establishment were made. And the result of the entire process may be told in these very few words,—that, at the present moment England has not in readiness the means of properly quarantining even a single ship.[4] It is not for me to say that this state of things may be deemed final. But if reversal of the policy which it expresses were ever so much desired, it could not be effected off hand. Enormous first expenditure of money in creation of proper lazarets would be wanted, as well as subsequent very large annual outlays for maintaining the necessary establishments. And the time which would be required for bringing the organization into work forbids the supposition that this could ever be done on emergency.

So, for England, under present circumstances, quarantine against cholera, as existing in the countries which are nearest to us, is a precaution of which there can be no serious thought. Were the country ever so ready to endure those extreme restrictions without which the whole thing is fruitless and absurd, the means for imposing them do not exist.[5] To extemporise a cordon sanitaire is simply and totally impossible; and no partial quarantine can be relied on for national purposes. Not only as regards cholera, but generally as regards all contagious disease, the position, which now has to be recognized and dealt with, is—that contagions current on the continent of Europe must be deemed virtually current in England.

Having regard, however, to our entire unprotectedness by quarantine against any contagions which may threaten us from abroad, I feel it additionally incumbent on me to insist on the present very imperfect state of our sanitary law and administration. Especially in view of the present re-infection of Europe by Asiatic cholera the necessity for a better state of things seems to me of the most urgent kind.

On the one hand I would beg leave again to refer to the evidence which is summed up in my last report, and is corroborated by new instances in the present one, as to the very ex-tensive inoperativeness of the Nuisances Removal Acts in England.

And on the other hand I would refer to the observations, which conclude my letter (Appendix No. 9.) addressed to the Lord President in April last, on the powerlessness of local authorities in regard of certain dangers of contagion. The footing on which the country now stands in relation to foreign contagions is, I apprehend, this:—that they have to be dealt with like our ordinary home-bred contagions; that, for preventive purposes, no action, or at least no’ effectual action, can be taken by the general executive of the country; that, so far as any good is to be got out of proceedings directly against contagion, this, like the good of indirect proceedings, has to be sought in the vigour of local authorities. It therefore becomes quite essential that the position of local authorities generally, in regard of contagion, should be reviewed. As to contagions already current in the country, practically any diseased person scatters his infection broadcast almost where he will—typhus or scarlatina, typhoid or smallpox, or diphtheria; and, under present circumstances, it cholera were in a district, the patient with choleraic diarrhoea would form no exception to the general licence. I cannot say that the exceptional case of the foreign infection seems to me of more importance than the every-day case of our native diseases; but I would venture to submit that, with regard to both classes indifferently, the present unlimited licence seems urgently to demand restriction. As in the case of typhus or typhoid, so also in the case of cholera: or, to use one general description, in the case of any dangerous contagious disease: the local authority, I submit, ought to have the power of requiring from the diseased person that, in regard of residence and otherwise, he shall so conduct himself as not unnecessarily to multiply the chances of extending his infection to others. Subject to the condition that proper hospital-accommodation can be offered, the authority ought to be able to enforce, in regard of any dangerous contagious disease, that the sufferer should not be in circumstances which promote the spread of disease to the general population. This power, exercised in seaport towns in relation to the poorer classes who might arrive infected from abroad, would in effect work thus:—such persons would be debarred from resorting to the common lodging-houses and crowded tenement-houses of the town, and would (as much to their own advantage as to that of others) be constrained to go to the local hospital, there to remain till cured. How far such a power for local authorities would be delegable to them under the Quarantine Act, or would require special legislation, is perhaps not a question of any ultimate importance, and is one which I am not competent to discuss. It deserves notice, however, that if the power in question were vigilantly used by local authorities, and in conjunction with other sanitary powers, its exercise would not of necessity be only of local effect, but might under some circumstances contribute, even importantly, to those national purposes which quarantine is intended to accomplish.[6]

 

[1] To the above-mentioned two kinds of precautions may be added, with regard to many important cases, a third, as follows:—So far as practicable, not to bring into personal relation with the sick, as attendants or otherwise, any persons who have not before acquired, or probably acquired, an insusceptibility to the existing disease. In typhus-epidemics, for instance, economies of valuable life may often be made by preferring for employment as nurses, doctors, inspectors, and so forth, persons who have already once had typhus. The same principle applies to many other contagions fevers; but I have no evidence that it in any degree applies to cholera. If I mention yellow fever in this note it is not with any intention of classing it as a contagious fever in the sense in which typhus is contagions; but, as the same principle of conduct is involved in both cases, this may be a convenient place for observing, that when yellow fever is epidemic in districts, persons to be sent into those districts ought, as far as possible, to be only persons who have already had that disease.

[2] The qualification with which the above opinion is guarded relates to the uncertainty how far the mysterious influence which starts, and perhaps accompanies, each pandemic extension of cholera, is an influence which creates new centres of “spontaneous generation” for the disease. As regards Europe, there seem to be strong presumptions against the likelihood that any such new centres are created. But this negative cannot be deemed absolutely certain; and of course the qualification becomes more and more important, in proportion as the country to which the question applies is near to those countries where cholera first had its beginning.

[3] It may be convenient to consider the restrictions in some detail, and with cholera to illustrate their bearing. The incubation-time of cholera, in the strict medical sense of the words—i.e. the time which elapses between the moment of infection and the moment when critical inquiry may first discover an altered (though perhaps but very slightly altered) action of the bowels, may be not more than two or three days; but practically the incubation-time of the disPnco must be regarded as of much longer duration—as continuing, namely, till the symptoms are so far developed that the sufferer cannot overlook or disguise them; and this point in the progress of the disease may not be reached till the first slight looseness of bowels’ (which many persons would overlook or deny) has continued for many days, or, it is said, even for weeks. If for the purposes of the argument we assume that an allowance of ten days will cover the time during which infection can be latent or designedly concealed: which, however, is less than the time on which quarantining governments insist, and I believe, only half the time of an average quarantine in Greece: and if we translate into practical language what this would mean, if England had quarantine against the continent: it would be, that ten days would be the minimum time in which any person, sick or healthy, could enter England from the continent—that, for instance, our present 90 minutes between Calais pier and the Dover railway-station would become an affair of at least ten days, and that no national advantage from quarantine could be promised, if this rule were in any single case relaxed or evaded.

[4] It may be proper to mention that the ceremonies to which, under the name of quarantine, certain trans-atlantic ships are subjected, on their arrival in this country, have not, properly speaking, any medical significance in relation to this country, but are part of an international obligation contracted for commercial reasons.

[5] When cholera last year broke out so vehemently at Alexandria, and was hitherto not in Europe, it would have been, comparatively speaking, a trifle to quarantine arrivals from that one port; not only because of their being few, in comparison with the innumerable arrivals from the ports of continental Europe, but also because, with the long voyage, the object of quarantine would generally have accomplished itself before arrival. And medically, of course, such a precaution was to be desired. But while my Lords still had it under consideration, whether to establish this amount of quarantine, and to provide the means of conducting it, cholera had already almost ceased at Alexandria, and had shown itself in other various ports. Before proper quarantine arrangements against Alexandria could have been organised, no quarantine would have been self-consistent which bad not been a quarantine against France, Turkey, Spain, Italy, and Germany, as well as against our own possessions of Malta and Gibraltar; and doubtless the contagium of cholera was in Southampton long before any effective arrangements could have been called into existence for excluding it.

[6] For obvious reasons it is only to a small extent that legal restrictions can avail to prevent the spread of such contagions as are once current in the country. They can only apply to conduct by which the public health is manifestly and directly endangered, and not to all kinds of such conduct. But in proportion as the physiology of contagion gets to be better understood by the public, the influence of legal restrictions will be increased by the appeals which well-informed persons will be able to make, and to which the example of such persons ought to give force, against all reckless conduct in such matters. Conditions of lodgment, as discussed in the text, are not all that require consideration. Complaints are often made of the freedom with which persons imperfectly convalescent from contagious fevers (as, very notably, from smallpox) expose themselves in places of common resort, and a careless sending of sick children to school often does much to spread diphtheria, scarlatina, and other contagious diseases; the careless transmission of infected things to common laundries, and of course the traffic in infected rags, imply dangers of the same sort; and against all such sorts of action the public ought to have some ready means of protecting itself. So, too, as regards the use of public carriages by persons contagiously diseased : no doubt a proper organisation for the conveyance of sick persons ought to form, part of the medical relief arrangements of every large town, and the use of the common public carriages ought then to be forbidden but if, as often happens in our present circumstances, persons who have smallpox and other dangerous contagious diseases cannot be taken to hospital except in common street cabs, surely the subsequent disinfection of every such carriage might be insisted on. Other dangers are for personal, rather than municipal, precaution. For instance, the modes by which puerperal fever is spread, and the extreme and fatal sensibility of puerperal women to the contagion of scarlatina, are matters which require, both generally from the public, and specially from persons who visit from one sick room to another, far more thought than is yet given to them. See App. No. 7., and Sixth Report, p. 59. Here also, I may observe, for the consideration of those whom it concerns, that our new institution of Turkish baths, used in common by swarms of persons—by some more or less for health, but by numbers also for mere enjoyment or curiosity, involves (inter alia) some awkward chances of syphilitic contagion : indeed Turkish baths are now among recognized means of treatment for persons with constitutional syphilis, who, in some cases, have local symptoms by which the disease can be communicated : and the question whether such patients take the general run of public baths, and are among the numbers who nakedly occupy the seats and couches of common sweating-rooms, is one which may greatly concern other frequenters of such establishments.

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How FALSE anti-vaxx panic and shutting down of vaccine producers forced USA to provide producers with protection

EXTRACT FROM Barry Glassner’s The Culture of Fear

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I discovered an example of legislation that curtailed lawsuits, generously compensated victims, and at the same time protected manufacturers, who ended up producing a safer product. The legislation, which created something called the Vaccine Injury Compensation Program, was instituted by Congress in 1986 as a kind of antidote to a countrywide hysteria that had begun four years earlier—on the evening of April 19, 1982, to be precise.

That night, during an hour-long news program titled “DPT: Vaccine Roulette,” broadcast on WRC-TV, the NBC affiliate in Washington, D.C., a new medical entity was given birth: the vaccine-damaged child. The program, illustrated with footage of severely handicapped children and heartbreaking testimonials from their parents, revealed that the pertussis (or “whooping cough”) part of the diphtheria-pertussis-tetanus (DPT) vaccine could cause horrible neurological disorders and even death. Over the coming weeks excerpts from “Vaccine Roulette” appeared on NBC’s “Today” show and in newspapers, effecting a media-generated panic. Pediatricians throughout the country were deluged with calls from panicked parents asking if their kids were going to die from the shots they had been given.

Medical and governmental organizations promptly responded to the flawed expose. Physicians at the FDA issued a forty-five-page, sentence-by-sentence refutation, copiously footnoted with studies from top medical journals, showing that deaths and serious complications result from the DPT vaccine either never or extraordinarily rarely. Other health officials and individual pediatricians also went to the media with evidence of their own about the safety of vaccines and the dangers from whooping cough itself. They reminded parents too young to remember that prior to 1949, when the vaccine was introduced, 7,500 children died from whooping cough and another 265,000 came down with various of its symptoms, which persist for five to twelve weeks and commonly include vomiting, seizures, and pneumonia on top of the violent coughing fits that gave the disease its name.

Injections of truth stand little chance of stopping the spread of a metaphoric illness, particularly early on. Much of the media downplayed the reasoned responses from physicians. And within weeks of the broadcast an organization called Dissatisfied Parents Together was formed by a victim-cum-expert, Barbara Loe Fisher, who recruited members and financial support with anecdotes about her son, whom she “watched convulse, collapse and go into a state of unconsciousness within hours of his fourth DPT shot at age two.”

By 1984, following media appearances, protest marches, and congressional testimony by Fisher and other parents, and mammoth lawsuits, two of the three manufacturers of the DPT vaccine had gotten out of the market, creating a dangerous shortage of the vaccine. Fewer children were being vaccinated, and health officials forecast an epidemic of whooping cough. They pointed to Japan, where a decade earlier panic over the vaccine had resulted in a ban on the drug, a tenfold increase in cases of whooping cough, and a tripling of the number of whooping-cough-related deaths. In England as well, although vaccines were available, immunization rates fell by 40 percent during a scare, and over an eight-year period 100,000 Britons came down with the illness.

It was against such a backdrop that the U.S. Congress, in a rare show of clear-headedness, enacted the legislation in 1986 designed to do four things at once: prevent a public health crisis, shield major drug companies from inevitable litigation, assuage parents who believe their children have been damaged by vaccines, and free the courts of interminable and highly adversarial trials. Financed initially by an $80-million-a-year federal appropriation, and since 1988 through taxes paid by vaccine manufacturers, the no-fault Vaccine Injury Compensation Program has largely met all four goals.

Public concern over vaccine dangers subsided after the program went into effect, due also to a couple of massive studies published in prominent medical journals and reported in the media. With a combined sample of nearly 1 million children, the studies demonstrated ever more definitively the relative safety of the vaccine. A child’s odds of brain damage or death from the disease of whooping cough, these studies showed, clearly exceed risks from the vaccine.

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