The Role of Nutrition in Social Medicine

Professor T. Ferguson (Institute of Hygiene, University of Glasgow) : It was inevitable that food and the nutritional wellbeing of the people should assume political importance and be major social problems long before there was much formal conception of social medicine. In classical times Juvenal wrote that there was nothing so effective as bread and plenty of diverting shows for keeping the people to their duty, and Ramazzini, in discussing the diseases of flour millers, pointed out how necessary it was to ensure for the people ample supplies of bread, for otherwise “bellies would rise in insurrection”. In Scotland, Hector Bocce, one of the early commentators on national diet, lamented that strength and vigour had failed among the people as they declined from the temperance of their elders, but not all visitors to Scotland in those early days found the same opulent gluttony, and Ray, a hundred years later, was frank in his criticism : the Scots neither had good bread, cheese or drink, nor would they learn to make them. The 16th century saw the introduction of measures for the control of food supplies and food policy. Stimulated by one of the periodic dearths, the Privy Council appointed a commission to make prices for all manner of victuals and to decide what steps should be taken to procure food for the people. The Commission drew up a schedule of rationing, which, however, was based on class distinction rather than on physiological needs. Tho year 1562 saw the introduction of the “political Lent”, certainly not the last occasion on which an attempt was made to clothe administrative expediency in the respectable garb of science or religion. During the 17th and 18th centuries, lean years recurred with monotonous regularity and reached a climax in the famine of 1698-99. It does not appear that any public measure was adopted for the relief of the poor a t this time; but in 1783, when famine was again present, the House of Commons voted money for the relief of distress in the northern parts of Scotland. The Glasgow weavers and their families made potatoes the main part of their food; many of them could get little else. Sinclair, the historian of the times, concluded that the principal dangers in the mode of living of the people arose from the use of potatoes and tea, and from the great abundance of spirituous liquors. The general reliance on potatoes as the primary source of food had catastrophic results when the crop failed in 1846. Oatmeal, which was scarce, came to be the staple food of the poor; a common basis of allowance seems to have been 1 lb. of meal per day per individual, sometimes “a degree less” to adult females. The dietary of the institutions of Scotland in the 19th century was bad. It observed the traditional reliance on meal, contained only a small amount of animal Conditions were still bad at the end of the 18th century.