“Epidemics such as the plague, cholera, and smallpox evoked sporadic public efforts to protect citizens in the face of a dread disease.”

“By the 18th Century, isolation of the ill and quarantine of the exposed became common measures for containing specific contagious diseases. Cities began to establish voluntary general hospitals for the physically ill and public institutions for the care of the mentally ill”.¹

“The great sanitary awakening’ (Winslow, 1923) -- the identification of filth as both a cause of disease and a vehicle for transmission and the ensuing embrace of cleanliness -- was a central component of nineteen-century social reforms.”¹

With the industrial revolution came increased urbanization, setting up conditions for the spread of disease in a filthy and unhealthy environment. With urbanization, the wealthy could not isolate themselves from the poor; disease became an indicator of social as well as individual problems.