Scarlatina and Sewer Smells: Metropolitan Public Health Records 1855-1920

he peculiarities of the history of public health in London have been the subject of several studies in the last twenty years, most notably by Anne Hardy, Bill Luckin, Lara Marks, Graham Mooney, John Davies and David Owen. The purpose of this contribution is not to add to the canon, but rather to make a plea for a re-examination of some of the original sources for this field, in particular the surviving reports of the metropolitan Medical Officers of Health (MOHs), which provide a unique insight, not solely into the development of public health policy and practice in the capital, but into many aspects of London life. London tended to be excluded from the provisions of much of the reforming legislation of the nineteenth century. It alone was left out of the 1835 Corporations Act, and the 1848 Public Health Act. This second Act decreed that, where a registration district recorded a death rate of over 23 per 1,000, the undertaking of remedial measures and the appointment of a Medical Officer of Health (MOH) became compulsory. In certain parts of London, most notably the East End, a death rate of