Environmental activism may be thought of as a relatively recent phenomenon. The Ultra Low Emission Zone now operating in central London is recognition of the deleterious effect on health of particulates from vehicle exhausts that has been well-established through research. In the 19th century the main air pollutant was coal smoke; yet its harmful nature was disputed – indeed some experts even claimed that by virtue of its antiseptic constituents the smoke was beneficial. It took an eminent eye surgeon and campaigning medical journalist to begin to set the record straight.
Ernest Abraham Hart, a dentist’s son, was born in Knightsbridge in 1836. After attending City of London School he began a stellar progression in the medical profession. In 1856, aged 20, he qualified from St George’s Hospital medical school, becoming a junior consultant specialising in ophthalmology at St Mary’s Hospital just two years later. And then, when still only 28, he was appointed Dean of St Mary’s. While he made some original contributions to ophthalmology, such as being the first to describe certain features of iris innervation, a meeting with the campaigner Thomas Wakley had already ignited a passion for social reform.
Wakley had founded the weekly medical journal, The Lancet, with radicals such as William Cobbett. By 1860 Hart was co-editor and his future now set firmly on the path of campaigning journalism, especially in the field of social and health reform. He was no stranger to agitating for the rights of others; even as a student he argued for naval surgeons to have professional status and his battles with the Admiralty and the War Office resulted in the rank, pay and privileges of medical officers being made equivalent to that of regular officers. He is most remembered as a journalist for his 32-year stint as editor of the British Medical Journal from 1866, during which time he grew the circulation from 2,000 to 21,000 while increasing the size of the journal from 20 to 64 pages.
Hart campaigned on social issues such as the conditions in poor law workhouses and the scourge of baby farming. His work on the former led to the establishment of the Metropolitan Asylums Board. The latter was a form of 19th century unregulated childcare whereby desperate single mothers unable to look after their children would place them with paid ‘foster’ mothers. These were commonly people unknown to the child’s mother and the unscrupulous carer would often find it cheaper to murder the infant once payment had been received. Hart helped to draft the Infant Life Protection Act, which was instrumental in putting an end to the practice.
Much of his efforts, as evidenced by his writings, were directed towards public health improvement. Topics such as the availability of clean drinking water to stem the spread of cholera and typhoid; the promotion of vaccination; diphtheria; and clean milk for Londoners all exercised his pen. But one of his greatest successes was in helping to improve London’s air quality – a campaign that had a ripple effect, not only across the UK, but in America too; his anti-smoke campaign stimulated the formation of similar movements in several American cities, including New York and Chicago.
The problem of coal smoke was not new, of course. As long ago as 1306 Parliament was complaining about the injurious effect on health and property of the use of coal in London. But, despite various protestations throughout the intervening centuries, the use of coal and the problem of air pollution steadily grew. In 1819 a Commons Select Committee was formed in order ‘to inquire how far persons using steam engines and furnaces could erect them in a manner less prejudicial to public health and comfort.’ A distinct impression of kicking the can down the road could be inferred from the formation of another Select Committee in 1843, whose members reported, ‘they received the most gratifying assurances of the confident hope entertained by several of the highest scientific authorities examined by them that the same black smoke proceeding from fires and private dwellings, and all other places, may eventually be entirely prevented.’ Needless to say, a third Select Committee, in 1845, concluded that, ‘in the present state of knowledge and experience upon the subject, it is not desirable to extend the provisions of an Act beyond furnaces used for the generation of steam.’
Elizabeth Blackwell
Driven by this parliamentary fudging of the issue, Hart set out to raise public awareness of the problem and to commission scientific research, aided by two remarkable women. He enlisted the help of the National Health Society, which was founded in 1871 by Elizabeth Blackwell as a vehicle for prevention of disease via health education. She was born in Bristol but emigrated to America with her family when her father’s business collapsed. She became the first woman in the United States to gain a medical degree and, thanks to its rules on recognition of foreign qualifications, the first woman to be registered with the General Medical Council. An unfortunate incident while treating an infant with neonatal conjunctivitis, in which she accidentally infected her left eye, led to the loss of sight in that eye and the end of her dreams of becoming a surgeon.
Hart’s other ally was Octavia Hill, another pioneering social reformer. Her mission was to improve the lives of the poor by enhancing their environments, especially through better accommodation provided by social housing and the availability of green spaces. An important vehicle for her work was the Kyrle Society, founded by her sister, Miranda. Together Hart and Hill, with the help of Blackwell’s organisation, in 1880 established the Fog and Smoke Committee, later renamed the Smoke Abatement Committee (SAC). The fruits of their research led them to organise the Smoke Abatement Exhibition the next year, held in South Kensington.
Octavia Hill
To capitalise on the growing evidence in favour of smoke abatement the SAC transformed itself into the Smoke Abatement Institution; Hart became chairman of the new body as well as of Elizabeth Blackwell’s National Health Society. He also became a member of the executive council of the International Health Exhibition, a larger version of the 1881 show, also held in London, in 1884. In a lecture for the exhibition Hart comprehensively quashed the assertion that the antiseptic properties of some of the carbon compounds found in coal smoke rendered the smoke a net benefit, with the aid of copious comparative mortality statistics from London and other metropolitan and rural areas. He also was able to illustrate the progress made since the 1881 exhibition. More efficient furnaces, and switching to gas, coke and anthracite coal were all having a significant effect.
A notable innovation was the introduction of gas jets to improve further a system for heating coke invented by Sir William Siemens, a German-born English engineer and inventor. Siemens’ system, developed with his brother, used the heat that would otherwise escape with waste gases to heat the air supplying a furnace, thereby improving efficiency. Interestingly from an optical viewpoint, it was first employed by the glassmakers, Chance Brothers, who found their fuel consumption dropped to a tenth of its previous level.
Hart yet found time to become an expert on Japanese art and rose-growing. His philanthropic works promoted research and scholarship; he was particularly keen to press for women’s entry into medical practice and personally provided money for two such scholarships. Diagnosed as diabetic in 1893, he had a leg amputated in 1897 and died the following year. Perhaps the greatest legacy of this ophthalmologist-journalist was the introduction, finally, of a Smoke Nuisance Abatement (Metropolis) Act in 1853.
David Baker’s new book, ‘Window of the Soul: A Brief Exploration of the Human Eye’ is published by FeedARead, and is available from www.feedaread.com, priced £6.99, and other online bookstores, including Amazon, at £7.99.
