Dr. Southwood Smith (1788 - 1861)

Dr. Southwood Smith was a great Victorian health reformer who became Minister for Health, 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in Somersetshire, began training to become a minister but could not accept all the church teachings and his grant was withdrawn.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 future King’s Cross Station. At this period, years before Pasteur, fever was a mysterious subject. Doctors could not distinguish one fever from the other. They still thought that disease was spread by smell (miasma) as the Greeks had done. It was before the realization that there were many forms of fever, with different causes. Bacterial infection was not understood. Everything was obscure. It would be generations before the different fevers were understood, and 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. There was also some connection between being in the same house all day and going out to work somewhere else all day, as men did.

He published reports on this. In 1833 he worked on the Factory Commission and in 1834 he published ‘The Philosophy of Health’ which was widely read. Three years later there was a serious fever epidemic in London and 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‘.

Later, Southwood Smith and his friends had 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.

The Association thought some houses could be built on these principles, but money had to be raised from shareholders. This was before the Limited Liability Act, so a special Act of Parliament had to be passed so that shareholders were liable only for the value of their share and not everything they owned (as Lloyd’s shareholders still are today).

The Association took the name ‘The Metropolitan Association for Improving the Dwellings of the Industrious Classes’ and its first venture was ‘The Metropolitan Buildings’ in Old Pancras Road, King’s Cross. They consisted of 110 sets of rooms, 20 two-room and 90 three-room flats, in five-storey blocks.

Southwood Smith published a book on the results of the experiment, and holding it in ones hand, in red cloth covers and tiny six-point type, is a vivid experience. In the three years 1850-52, child deaths in the Buildings were only one third those of the Metropolis as a whole. The contrast to The Potteries, in Ladboroke Grove) was even greater.

(The average age of death was twelve years. Sanitary Report for 1856.)

In 1861, Hollingshead described The Potteries as, ‘a marshy district lying between the villas of Bayswater and Notting Hill.- - - (It had) highways not yet adopted by the public and consequently dedicated to nothing but rivers of mud. The inhabitants are pig-trainers and brick makers, ‘fanciers’ of spurred gamecocks, and red-jawed bull terriers. The huts have grown a little the worse for wear. Refuse matter is still collected by the pig-trainers and boiled down in coppers, that the fat may be separated for sale.

Southwood Smith wrote:-

‘In The Potteries, Kensington, an un-drained area in Notting Hill with no supply of clean water or method of removing filth, the child mortality was 51 in about 384. So the Potteries, with 80 fewer children, had 41 more deaths than the Metropolitan Buildings.

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.

References to Southwood Smith in this website

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