Abstract
The nineteenth century was a time of paradox — the third quarter, generally regarded as an age of unprecedented prosperity, also reached high-water levels of mortality and pauperism. Everywhere was much that was squalid. The popular attitude to health was less than enthusiastic and administrative machinery was largely ineffective. Such machinery as there was, was busily occupied with attempts to mitigate gross environmental abuses. But the stage was being set for major advances in personal health services that came with the new century.