William Pulteney Alison : activist philanthropist and pioneer of social medicine
Abstract
The thesis looks in detail at three inter-related aspects of
Alison's life. It examines, firstly, his role in the development
of Edinburgh's rudimentary 'health' network, achieved through the
expansion of the existing medical charity structure and the
introduction of a more interventionist and coordinated approach to
the city's health problems. It traces, secondly, the development
of Alison's social thought - in 1820 he believed that medical and
practical relief for the poor could and should be supplied through
the voluntary charities and only when that proved unsatisfactory
through the poor law, whereas by 1840 he argued that public health
should be the responsibility of government and that the excessive
increase in poverty and disease in Scotland, which he believed had
occurred, was proof that the charitable and legal relief provided
was inadequate. Finally, Alison's influence on the passage of
Scottish poor law and public health legislation in the 1840s and
1850s is examined - the latter involving an assessment of how far
he was responsible for the legislative delay. The poor law debate,
1840-1845, which reveals the forces shaping the reform and the
prevailing attitudes to poverty, highlights the challenge which
Alison's opinions represented and the resulting turmoil in Scottish
social thinking, while his reasons for opposing health legislation,
which established London control are of great importance. They
reveal differences in the rationale behind, and way in which, the
concept of public health was developed in Scotland and England.
Unlike Chadwick and his supporters, Alison emphasised poverty
amelioration and sanitary reform. Part of the explanation for the
differing opinions lay in their respective miasmatic and
contagionist theories for fever generation, but it also reflects,
perhaps more significantly, the impact of European medical police
ideas on Scottish medical opinion - Alison's view of public health
closely resembled that of the French hygienists.
Type
Thesis, PhD Doctor of Philosophy
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