The civil servant Edwin Chadwick (1800-1890) dominated public health policy from 1848 until he was obliged to take early retirement in 1854. Historians have concluded that his activities after 1854 produced no lasting impact. That analysis did not evaluate his contribution to the 1875 Public Health Act. This paper describes how the coordinated activity of Chadwick, Florence Nightingale, and William Farr between 1858 and 1871 produced one of the most successful social reforms in modern history. Unaware of the intellectual capital that this group provided to political decision-makers, historical accounts have tended to attribute the reduction in mortality post-1875 to a natural organic process responding to evident social evils. The rise, fall, and rise again of Chadwick's influence on public health policy shows how, on the contrary, difficult choices are necessary to resolve social problems.
Keywords: 1875 Public Health Act; Edwin Chadwick; Florence Nightingale; sanitation.