'That the inhabitants of this kingdom have of late years changed their way of living in a very remarkable manner, and greatly increased in luxury, is a truth of which every person, who has lived any time in it, must be sensible,' wrote the economist Adam Dickson in 1773.1 By then the age of 'heroic' sectarian Protestantism had long passed;Quaker Friends no longer interrupted sermons or went naked in the street while they were busy making their fortunes. Borrowing a phrase from John Bunyan, the old Dissenters were crossing 'the plaine of Ease', at the edge of which lay 'a little hill called Lucre, and in that hill a silver mine', beyond which stood 'Doubting Castle'. The new United Kingdom's population rose steeply from c.10.5 million in 1750 to 15.5 million in 1801. There were only four new bodies of English local civic Improvement Commissioners set up between 1700 and 1749;over the next fifty years, by 1800, there were 567.2
The hygienic changes during the first fifty years of the eighteenth century were still mainly personal and economic ones— most of them occurring in people's minds and inside private homes. The result was a new market for health care. The thriving eighteenth-century health and leisure industries were blatantly connected to the fast-accelerating 'wheel of fashion'—a new vortex of consumerism that had emerged from unprecedented European mercantile expansion and surplus wealth.3 But life was still harsh, brutal, and short if you were born at the bottom of the heap;and there was only the germ of an idea, around 1750, that these immemorial conditions could be 'improved'. In the second half of the century, in England, France, and Germany especially, there was renewed interest in the utility of public hygiene, coupled with the first tentative moves towards hygienic public health policies, based on statistics and natural science. Just to keep these wider social developments in perspective, however, the leap of the imagination required to make a connection between the old idea of private hygiene and new idea of public hygiene is reflected in this footnote from the amateur health bibliophile and reformer Sir John Sinclair, uncertainly attempting to redefine personal hygiene as a social science in 1802:
Good health and longevity depends much upon personal cleanliness, and a variety of habits and customs, or minute attentions that it is impossible here to discuss. It were much to be wished, that some author would undertake the trouble of collecting the results of general experience upon that subject, and would point out to those habits, which, when taken singly, appear very trifling, yet when combined, there is every reason to believe, that much additional health and comfort would arise from their observance.4
Only five years later, however, he was confidently advocating the new European philosophy of 'medical police', namely,
1. Police of Climate. 2. Police of Physical Education. 3. Police of Diet. Police of Public Amusements. 4. Police of Habits and Customs. Police of Public Institutions. 7. Police for the Health of Soldiers and Sailors. 8. Police to Prevent Contagious Disorders. And, 10. Police of Medicine and the means of promoting its improvement.5
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