Illustrations of the practical operation of the Scottish system of management of the poor / by W.P. Alison, M.D., Professor of the Institutes of Medicine in the University of Edinburgh.

  • Alison, William Pulteney, 1790-1859.
Date:
[1840]
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Licence: Public Domain Mark

Credit: Illustrations of the practical operation of the Scottish system of management of the poor / by W.P. Alison, M.D., Professor of the Institutes of Medicine in the University of Edinburgh. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    of the town to another, and introduced the disease into three different districts, all inhabited by very poor people ; and I traced not less than fifty cases of the disease to communication with that family, notwith- standing that several of its members were successively taken into the hospital. I think myself justified, from the very frequent observation of such facts, in applying the experience of physicians in general in all coun- tries, and especially of those who have witnessed the fever in Ireland, to its extension in Edinburgh, and concluding that the “ want and mi- sery” of a certain portion of the inhabitants, and the filth within the houses, the crowding, the negligent and reckless habits, and the occa- sional intemperance, which are the usual concomitants, and I believe the natural results, of this want and misery, are with us, as in Ireland, the great predisposing causes of fever, to which its frequent and general diffusion in this and other large towns in Scotland is chiefly to be as- cribed. And when I compare this state of things in these towns with the comparatively limited extension of contagious fever in most of the great towns in England, of which I have elsewhere given some examples,* and reflect on the resources which are there provided for persons likely to fall into a similar state of destitution, I cannot doubt that it is to the existence of the compulsory provision against indigence in England that the comparative exemption of the great towns from this great evil, of which I have elsewhere quoted proofs, is mainly to be ascribed. I need hardly say that, according to the practical administration of the poor laws in Scotland, there is no legal provision for that destitution which results merely from want of employment; and that the allowances to aged, infirm, and disabled persons, and to widows and orphans, are so small, as in many instances not to preserve them from the state of destitution which, in the judgment of all experienced observers, gives the strongest predisposition to attacks of epidemic fevers. The account of the Leeds House of Recovery for 1839 gives a striking illustration of the difference, in this respect, between the Eng- lish and most of the Scotch and Irish towns. It is there stated that fever had appeared during the year in no less than 101 different streets or courts in that town; but the whole number of patients received from all these districts was only 201. This fact I consider as much stronger evidence of the efficiency of some cause or causes there acting, and re- sisting the extension of the disease, than the more partial introduction of fever into the town would have been. In like manner, in the Report just published by Dr. Jenks, on the Sanatory State of Brighton, it is stated that the whole number of cases strictly designated as fever occurring there, in a population of about 40,000 persons, was 76 in a year (1839), notwithstanding that the dis- ease appeared in almost all parts of the town, and furnished more in that and the preceding year than for fifteen years previously. I must admit that the number of deaths from fever, reported in the two first Reports of the Registrar-General of England, is considerably greater than I expected, although , not more than 16*7 per cent, of the general mortality, and not more than one-third of the mortality from * On the Management of the Poor in Scotland, 2nd Edition, p. 16. c