We tend to forget what a wealth of expert knowledge about healthy housing conditions Octavia Hill, had absorbed, almost by osmosis, before she ever came into the field herself. When her father became too ill to support the family, her grandfather, Dr. Southwood Smith (1788 - 1861) the great Victorian health reformer, took responsibility for the family.
He was born in Mortock, in Somersetshire, began training to become a minister but could not accept all the church teachings and his grant was withdrawn. His family, which was narrowly religious, cast him off at once and for good. He married but his wife died young, leaving him at the age of 24 with two young children. In 1813 he decided to leave the children in the loving care of his wife's relations and study medicine at Edinburgh University.
Passing his examinations in 1816, he married again, this time to a girl from Hackney, and came to London. He was appointed to The London Fever Hospital, then on the site of Kings Cross Station.
At this period, years before Pasteur, fever was a mysterious subject. Doctors could not distinguish one fever from the other. It was before the realisation that there were many forms of fever, with different causes. Bacterial infection was not understood. It was before the concept of immunity built up by the body. Everything was obscure. It would be generations before the different fevers were understood. In the meantime, Southwood Smith's thoughts were concentrated on how fevers in general might be prevented.
The Fever Hospital patients seemed to show a pattern. Patients (mainly women) came in with 'a low fever', were cured by rest and nursing, returned to their miserable homes, only to develop fever again. There seemed to be a connection between poor living conditions and ill-health.
He published reports on this. In 1833 he worked on the Factory Commission. In 1834 he published 'The Philosophy of Health' which was widely read. In 1837 there was a serious fever epidemic in London. Southwood Smith was appointed to report on East London. From this came 'The Report on the Physical Causes of Sickness and Mortality to which the Poor are particularly exposed and which are capable of prevention by Sanitary Measures'.
As a result of this and similar reports by Southwood Smith and others, the Contagious Diseases Act, The Public Health Act and The Metropolitan Sewers Act, were all passed before 1848, the year when he was appointed to the Board of Health.
Southwood Smith and his friends carried out a deliberately planned experiment to try to prove that good housing would help to produce good health. In 1842 a few individuals formed themselves into an Association to prove that health could be improved by building houses on well-drained sites; admitting light and fresh air into every inhabited room; abolishing cess pits (earth closets) and introducing water closets; supplying abundant clean water and removing rubbish regularly.
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