In general all epidemics and all infectious diseases are attended with charges, immediate and ultimate, on the Poor Rates. Labourer are suddenly thrown by infectious disease into a state of destitution, for which immediate relief must be given. In the case of death, the widow and the children are thrown as paupers on the parish. The ammount of burthens thus produces is frequently so great as to render it good economy on the part of the administratoes of the Poor Laws to incur the charges for preventing the evils where they are ascribable to physical causes, which there are no other means of removing. The more frequent course has been, where the causes of disease are nuisances, for the parish officers to indict the parties for nuisances, and to defray the expenses from the Poor Rate. During the last two years the public has suffered severely from epidemics. At the present time fever prevails to an unusually alarming extent in the Metropolis, and the pressure of the claims for relief in the rural Unions on the ground of destitution caused by sickness, have recently been extremely severe.

Commissioners' letter to Home Secretary, 1838, published as App.A, No.I, Forth Annual Report of Poor Law Commission. Drafted by Chadwick. F 156 n.1.

John Simon regarded this passage as an entirely new sort of government action and the first step in the modern utilization of medicine by the State. John Simon, Sanitary Institutions, 184-185.