Balancing Public Health and Personal Liberty

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Recommended: The origins of public health in the 19th century

Public health practice in the nineteenth century mainly focused on sanitary reforms such as clean water, efficient sewage system, garbage collection and disposal, fumigation practices and clean housing facilities. This was mainly attributed to the filth theory which was widely accepted during that time. These sanitary measures were necessary to keep the infectious diseases such as smallpox, cholera and typhoid under control so as to prevent their epidemic outbreaks. However, in the early twentieth century, the advent of germ theory shifted the focus of public health from sanitary reforms to the laboratory. This changed the outlook of public health officials leading to alterations in the treatment procedures of the disease which were now concentrated mainly on the elimination of bacteria causing the disease. (Rosen, G.,1993)
A very good example to support this change is the stand taken by the officials to eliminate typhoid fever during the end of the nineteenth and the early twentieth century. Since typhoid had been established as a water- and food-borne systemic bacterial infection, officials mainly concentrated on sanitary reforms to curb the disease. Though these efforts considerably reduced the number of cases of typhoid fever, they could not completely eliminate the disease. With the increase in bacteriological studies in the early twentieth century, it became evident that healthy people could carry the Salmonella typhi bacteria in their excreta and could cause the spread of typhoid. These individuals were termed as “healthy carriers” because though they appeared healthy, they could still cause the disease to spread. (Leavitt, J.W.,1992)
Mary Mallon infamously known as “Typhoid Mary” was identified as the first healthy carrier...

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... Retrieved from http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2004.055145
Jones, M., & Bayer, R. (2007) Paternalism and its discontents: motorcycle helmet laws, libertarian values, and public health. Am J Public Health;97(2):208-17.
Knowles, J.H., (1977). The Responsibility of the Individual, Daedalus;106;57-80.
Leavitt, J. W. (1992). “Typhoid Mary” Strikes Back Bacteriological Theory and Practice in Early Twentieth-Century Public Health. Isis, 83(4), 608-629.
Mariner, W. K., Annas, G. J., & Glantz, L. H. (2005). Jacobson v Massachusetts: It’s Not Your Great-Great-Grandfather’s Public Health Law. American Journal of Public Health, 95(4), 581–590. doi:10.2105/AJPH.2004.055160
Rosen, G. (1993). A History of Public Health. Johns Hopkins University Press.
Parmet, W. (1985). AIDS and quarantine: the revival of an archaic tradition. Hofstra Law Review 13: 53-90.

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