William Pulteney Alison

William Pulteney Alison (12 November 1790, Edinburgh - 22 September 1859) was a distinguished professor of medicine in Edinburgh University, and a philanthropist. He married his first cousin Margaret Craufurd/Crawford Gregory (1809–1849), daughter of James Gregory in 1832; the marriage was childless.

Alison was the son of Archibald Alison, a brother of Archibald Alison and godson of Laura Pulteney, 1st Countess of Bath. In his youth he climbed Mont Blanc and other mountains as a pastime and in 1811 he graduated as a physician from Edinburgh University. Struck by the poverty he encountered Alison advocated poor relief in Scotland be extended from the sick and infirm to include the healthy impoverished. This was a radical suggestion as the ethos of the age was for poor relief to be withheld from the able-bodied destitute who were presumed to be indolent and sinful.

Alison proposed using the (Scottish) Poor Law to alleviate poverty as a means of assuaging disease, but the Poor Law Commissioners supported the position of English reformer Edwin Chadwick that disease was caused by filth and miasmas. Alison held to the contagion theory of disease, stating its spread was facilitated through poverty and overcrowding. He argued that poverty arose from social factors, not sin and sloth, and that higher wages should be paid to workers to mitigate disease by reducing the effect of overcrowding and destitution. In stating a case for fighting disease that appeared to be outside the province of contemporary medicine Alison was a pioneer of “political” medicine, as well as social epidemiology and public health.

In his 1840 publication Observations on the management of the poor in Scotland and its effect on the health in the great towns, Alison argued that the government and its agencies had a major role in the alleviation of poverty and that this undertaking should not be left to religious groups or private charities. He advocated using public taxes to assist widows, orphans and the unemployed poor, and criticised the establishment for ignoring those who were fit but impoverished. The findings of the 1844 Royal Commission on Poor Laws (Scotland) lent support to Alison’s viewpoint.

Alison promoted preventive social medicine and initiated a program to vaccinate children against smallpox, and he established Edinburgh’s Fever Board to combat epidemics. He advocated speedy diagnosis of the ill and, where found to be contagious or infectious, he recommended fumigation and ventilation of the residence and prompt hospitalisation for the patient. His methods bore fruit during the cholera epidemic of 1831-1832, whereby Edinburgh took immediate and effective action to mitigate the outbreak without awaiting instructions from London.

In strongly advocating government intervention to alleviate poverty as a means to combat disease Alison was ahead of his time but he lived to see public opinion move closer to his initiatives.