YALE JOURNAL OF BIOLOGY AND MEDICINE 80 (2007), pp.61-72. Copyright © 2007. ARTS & HUMANITIES City Chaos, Contagion, Chadwick, and Social Justice Ian Morley Department of History, Chinese University of Hong Kong In 1842, a civil servant, Edwin Chad- wick, published at his own expense The Re- port from the Poor Law Commissioners on an Inquiry into the Sanitary Conditions of the Laboring Population of Great Britain, which outlined in detail the wretched social and environmental conditions within the world’s first industrial society. The Chad- wick Report, the first such national investi- gation of its kind, highlighted a number of now widely accepted phenomena concern- ing economic development, urbanization and health within industrial settlements. For its time, the report was a monumental step toward accepting and then dealing with the social costs of economic progress. In short, the Chadwick Report established that material progress did not equate inter alia to a universal improvement in urban health. Instead, it revealed how modern cir- cumstances had the ability to establish a health schism between social groups. So with such a backdrop in mind, this article assesses the role of Edwin Chadwick and his 1842 sanitary report in the lead-in to the Public Health Act (1848), a legislative at- tempt to bestow social and health equity in Britain, and examines the wider social and medical context within which the world’s first modern system of public health emerged. Demonstrating how the sanitary movement was formed and how miasmic medical notions influenced the form of the 1848 Act, this paper will appraise a variety of factors that helped shape the evolution of epidemiology within what was the world’s first industrial and urban society in the 1830s and 1840s, including the realiza- tion that societal advancement did not cre- ate health benefits for all. BACKGROUND At the end of the 18th century, when the initial stages of industrialization were under way, the British population was esti- mated to be less than 10 million people, of which about 30 percent of the populace resided in urban communities. By 1841 [1], immediately before Edwin Chadwick pub- lished his Report from the Poor Law Com- missioners on an Inquiry into the Sanitary Conditions of the Laboring Population of Great Britain (hereafter known as the Chadwick Report), the quantity of urban dwellers was approaching 50 percent of the nation’s population total, and a number of broad developments had been noted about the size, appearance, density, heterogeneity, To whom all correspondence should be addressed: Ian Morley, Department of History, Chi- nese University of Hong Kong, Shatin NT, Hong Kong SAR; Tele:+852-2609-7116; E-mail: ianmorley@arts.cuhk.edu.hk. 61