Reporting Dirt and Disease: Child Ill-health in Eighteenth-Century England’

Poor bodies were both worrying and threatening in the eighteenth century. Medical depictions of poverty in discussions of contagious diseases presented it as degrading the human constitution with dangerous ramifications for pathology. High levels of infant and child mortality also forced reflection about the seemingly precarious health of society's youngest. Thus the poor and children were each in their own ways portrayed as prone to illness and contagion in the eighteenth century. What, then, of poor children? Were they inherently sickly? The issue is not so simple for when the issues of poverty and childhood conjoined one encounters mixed messages. On the one hand, poor children were poor. In theory they presented similar contagious risks to those posed by their parents. And yet, certain elements that commonly coloured medical narratives about poverty were either absent in discussions of children or else deployed differently with different effects. Ambiguity thus characterises medical narratives on poor children, whether because discussions of children frequently lacked the heavy moralizing that so often characterised commentaries on the poor, or because different agents crafted such narratives in different contexts and with different concerns. This article will compare narratives found in medical treatises that sought to explain the causes of disease with a quite different viewpoint created by the authorities charged with the actual bodies of poor young children. 1 If, as cultural anthropologists argue, narratives give shape and meaning to human experience (Mattingly and Garro 1-5), then an exploration of how various commentators made their claims about poverty, age and sickness can shed light on their deeper concerns and assumptions, for example, about social order, governance and the state of the population. Doctors facing the possibility of epidemics were primarily concerned with identifying sources of infection. Thus they told tales, whether expressed as outbreak narratives or metaphorically rich medical theories, that emphasised the role of poverty and filth. The possibility that poor children might be inherently sickly was a by-product of narratives that emphasised heredity causes of disease, and at least one high profile example took these trends to their logical conclusion presenting sick children as a significant public health threat. However, men who were actually responsible for poor children addressed issues of health rather differently, being primarily concerned with reacting to the realities of spots, itches and fevers and how best to contain them. On the one hand, this article argues for differentiating between abstract theorists and pragmatists on the ground. However, this difference found expression not only in the content of the claims being made but in the form of those claims as well, for these latter commentators crafted narratives that allowed little space for seeing poor children in ways implied by medical theory. When thinking about narratives about the sickness of child paupers therefore, evidence suggests that their health was increasingly noted and valued; their bodies increasingly observed; and their ill-health largely divorced, at least on the ground, from the wider discourses about heredity, corruption and poverty seen in the contemporary medical tracts.