View report page

He was cheered by the Court when he finished his report. Charles Kingsley when he read the
cholera report in his newspaper, wrote of Simon "verily the days are coming when as the Prophet
says 'a man shall be more precious than fine gold' — your efforts are helping towards this good
end". The Times reported "Mr. Simon speaks as a practical man who is not willing to go an inch
beyond that which he has with his own eyes recognised for truth. He had not enforced general
laws on a priori notions but had done in each instance exactly as much as was needful. The credit
he tacitly claims, he has fairly won".
The Public Health Bill of 1858 made provision for the appointment of a Medical Officer to
the General Board of Health and Simon was the obvious man for the job. He had shewn himself to
be a practical and able exponent of preventive medicine in local government, so the first M.O.H.
of the City became the first but not the last M.O.H. to be appointed medical officer of the central
government health department. We find in Simon's conception of a single central health department
legislating to the level o* the acceptable findings of medical science in the field of public
health in which he included "care for the physical necessities of human life". So in this department
he envisaged control not only of water supply and drainage but he mentions other matters
concerned with the River such as the regulation of emigrant ships, quarantine and preventive
vaccination, ailments of London dockers. In fact he set up his enquiry as the result of a case
at St Thomas's Hospital and this was the first of a series of government investigations into
industrial health which he was to initiate.
Now as Medical Officer of the Board, Simon prepared a report on cholera concerning the
question of the connection between the outbreaks and sewage contaminated water supply. This
was his definite reply to this great sanitary question. In 1855 the Committee for Scientific
Studies had refused to confirm any definite connection between the two and asked for research
into the problem. John Snow had already given a report of practical proof in the wellknown Broad
Street Pump outbreak, and William Farr had carried out an epidemiological analysis of 1854 in
South London as affected by the water supply. Simon's report elaborated these investigations and
covered both epidemics of 1848 - 49 and 1853 - 54 and the half million living south of the Thames
supplied by two different water companies (Southwark and Vauxhall — and the Lambeth). The
Lambeth supply had its source of intake at Ditton whereas the Southwark Company still pumped
unfiltered water from the Thames at B attersea purveying perhaps the filthiest stuff ever drunk
by a civi li sed community. Lambeth Company deaths were 37 per 10,000 and for the Southwark
Company 130 per 10,000 i.e. population drinking dirty water suffered 3Zi times the mortality of
the population drinking different water. From these and other facts Simon proved conclusively
the danger of drinking faecalised Thames water during cholera outbreaks. He reached this conclusion
empirically and statistically by retrospective examination of the evidence without much
understanding of the nature of cholera, contact infection or isolation of the specific organism.
He concluded that this was one cause — he still thought the atmospheric theories remained
plausible. He drew the practical conclusion that sewgae should be diverted from the river to
land. Following the memorable great stink of 1858 when the nauseating al l-pervading stench from
the Thames made the purlieus of Westminster barely endurable — (Adderley states the nearby
Thames 'might soon be a terror to this house') — Simon set William Ord to report on the stinking
state of the Thames and its effects on health.
In 1862 - 3 he appointed another specially commissioned expert Dr. Robert Barnes of the
Naval Medical Service to investigate the prevalence in the mercantile marine of scurvy. Barnes
showed that the disease persisted because employers deliberately ignored imperative dietary
provisions of the Merchant Shipping Act, 1854. In his Sixth Report, Simon demanded "particular
inspectional regard for the enforcement of the law". The Merchant Shipping Act, 1867 sponsored
by the Board of Trade established a medical inspectorate of mercantile marine as Simon desired
and eradicated the suffering he had condemned.
Again in 1865, faced with the prospect of a fourth European epidemic of cholera, Simon
guessed how effective in the light of the new scientific knowledge would 'the paper plausibilities
of quarantine' prove. He maintained that contagions current on the Continent of Europe
should be deemed virtually current in England, so he demanded greater powers for local authorities
over the individual and his actions to limit the spread of infectious diseases, such as compulsory
removal to isolation hospitals, transfer of dead bodies to mortuaries, disinfection of infected
articles and conveyances, and prevention of infected persons appearing in public places or
using public conveyances. This, he held would be more effective than any national quarantine.
Travelling from the Near East and Mediterranean rather than from the Baltic as formerly,
cholera appeared in England in the late summer of 1865. Next spring isolated outbreaks occurred
in ports, including London where there was heavy emigrant traffic, and the outbreak by July was
generally epidemic throughout the country and reached its climax in August especially as a water
borne epidemic in East London, but rapidly subsided and was mild compared to the three earlier
epidemics, though even in this 14,378 died. Simon presided over this major outbreak and rigidly
refused to impose a general quarantine but used the powers of the Disease Prevention Act, extending
it to the whole country and helped local action. Simon sought to set up a research team
into the treatment, biochemistry, symptoms and communicability of cholera with the aid of seven
eminent London doctors, and made a demand on the Treasury for a £2,000. grant for this purpose.