‘Sick and In Prison’: Airborne Disease and Prison Reform in the career of John Howard (1726–1790) 

By Dr. Paul E. Sampson, Assistant Professor of History, The University of Scranton 

2020 Audrey and William H. Helfand Fellow in the History of Medicine and Public Health 

Over the course of the past year, I have had the privilege of spending four weeks researching in the spectacular rare book collection of the Library of the New York Academy of Medicine. My book project is entitled “Ventilating the Empire: Environmental Machines in Britain, 1700–1850” and comprises a scientific and social history of ventilation in Britain and the British empire during the long eighteenth century, roughly 1688 to 1815. By examining the design and deployment of ventilating machines in slave and naval ships, prisons and public buildings, I ask how devices designed to protect human beings from environmental hazards became a means of dividing British society along class and racial lines.  

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The primary subject of my research has been the life and career of prison reformer John Howard (1726–1790). I examine Howard’s career through the context of his work on “Jail Fever” (AKA typhus) which contemporary physicians and medical experts understood as an airborne disease. I argue that a key feature of Howard’s celebrity was his perceived invulnerability to airborne diseases. In addition, his influence helped to shift the discourse of prison reform away from overall institutional sanitation and towards methods intended to control the hygiene and morality of individual prisoners. 

For those unfamiliar, John Howard was a noble-born, intensely religious man who was appointed sheriff of Bedfordshire in 1773. One of his duties was to inspect local prisons. Unlike many of his genteel contemporaries, he took this job seriously. He was appalled by the conditions of the prisons in Bedfordshire, and to spur reform and gather ideas for improvement, he made a series of lengthy tours to visit as many prisons as he could throughout the British Isles and continental Europe. His first published book, The State of the Prisons in England and Wales (1777), detailed his visits to dozens of county jails and bridewells (workhouses), including careful notes of the fees charged to prisoners, their daily workload, the prison diet, and the overall sanitation.  

One of the primary goals of Howard’s travels was to find the best means of preventing the spread of disease. By the 1750s, prisons were increasingly perceived as public health hazards. The filthy and diseased condition of prisoners in London’s Newgate prison became a public scandal after the Lord Mayor and 56 others died of jail fever in the weeks following an audience with prisoners. Following the contemporary etiology of fever, the outbreak was attributed to the “putrid effluvia” exhaled in the breath of sick prisoners that had imparted a “poisonous quality” to the air in the courtroom.1 By 1774, Howard had achieved celebrity status by helping to author the “Act for Preserving the Health of Prisoners in Gaol.” This act stated that jail fever was caused by the “want of cleanliness and fresh air” and mandated that all interior walls and ceilings be scraped and white-washed annually and “constantly supplied with fresh air, by means of hand ventilators or otherwise.”2  

However, in the wake of this achievement, Howard’s attitudes about preventing fever had begun to shift. During his tours of European prisons, he was puzzled that he rarely encountered “jail distempers” there. To explain the disparity between these and disease-ridden English institutions, Howard developed a theory of jail fever based entirely on his own “experience.” He argued that prisoners could only be infected if privation, filth, and personal intemperance weakened them enough for the contagion to take hold. Young and healthy convicts who were used to “vigorous exercise” quickly became infected due to the “sudden change of diet and lodging” that “so affects the spirits of new convicts, that the general causes of putrid fevers exert an immediate effect on them.” As a counter-example, Howard pointed to himself. During his first tours, he wrote, he had attempted to avoid breathing in contagion by “smelling to vinegar… and changing my apparel…constantly and carefully.” A few years later, however, he wrote that he “entirely omitted” such precautions. In his opinion, the real protection against infection were his habits of “temperance and cleanliness” as well as the power of “divine providence.”3 

Image 2: Howard was keenly impressed by the prison regime in Bern, Switzerland. Howard wrote that the city was “one of the cleanest I have seen” and included illustrations of the employment of male and female prisoners as street cleaners. Note the iron collars with hooks affixed to the prisoners’ necks to deter escape attempts.  
“Employment of Criminals” and “Employment of female Criminals,” in John Howard. The State of the Prisons in England and Wales. 2nd. Ed. (Warrington: T. Cadell, 1780) 109–10. Images courtesy of the New York Academy of Medicine Library. 
 

By the time the second edition of State of the Prisons came out in 1780, Howard had visited hundreds of disease-ridden institutions and avoided contracting a serious infection. While friends privately cautioned him against such continual risk-taking, Howard’s superhuman invulnerability to disease had become a key feature of his celebrity.4 Celebratory poems about Howard became, in the estimation of two literary scholars, “nearly ubiquitous in the 1780s and 1790s” as poets from Erasmus Darwin to William Cowper celebrated his arduous travels and selfless virtue.5 William Hayley’s 1780 Ode, Inscribed to John Howard attributed Howard’s “matchless fame” to his “valor’s adventr’ous step” through “malignant cells” where “fierce contagion, with affright, repels.”6

Image 3: George Romney’s study for a never-completed painting of John Howard visiting a prison or lazaretto. Howard is the figure standing defiantly on the far left.  
George Romney, John Howard Visiting a Lazaretto (1790–95). Courtesy of the Museum of Fine Arts, Boston, MA. 
 

This vision of Howard as a heroic and invincible figure appeared in numerous prints and lithographs and was captured evocatively in an unfinished work by famed painter George Romney, who depicted a defiant Howard striding confidently into scenes of melodramatic suffering and disease.7  

Despite his reputation, Howard wasn’t able to evade contagion forever. While travelling through southern Ukraine in the winter of 1790, Howard contracted a serious fever and died two weeks later.8 Notwithstanding his untimely death, Howard’s emphasis on invigorating labor, self-regulation, and instilling personal hygiene in convicts exerted an enormous influence. By the heyday of the modern penitentiary in the mid-nineteenth century, Howard was lauded as the founder of “prison science.”9 While jails designed during Howard’s life reflected the eighteenth-century emphasis on eliminating effluvia via ventilation, their nineteenth-century successors focused instead on insuring that each inmate was placed in solitary confinement and given a strict regimen of work and moral instruction.10  

In my larger project, I argue that this is partially due to a shifting locus of responsibility for preventing airborne disease. The attention of reformers shifted from the condition of the institution to the character of the individual, who became responsible for his or her own cleanliness and ventilation. To briefly illustrate this point, I will conclude with a quotation written several years after Howard’s death by naval health reformer Gilbert Blane: 

Those only whose duty leads them to consider the subject, are aware how much the welfare of the human species depends on ventilation and cleanliness; and no one could render a greater service to his fellow creatures, than to impress on their minds the necessity of cultivating them as moral and religious duties.11 


1. See, for example: John Pringle, Observations on the Nature and Cure of Hospital and Jayl-Fevers (London: A. Millar, 1750); “Account of the Fatal Assize,” CLA/035/02/049, Gaol Committee, 1750–1755, Notes on Ventilating Newgate, London Metropolitan Archives.

2. Act for Preserving the Health of Prisoners in Gaol and Preventing the Gaol Distemper, 1774, 14 Geo. III, c. 59.

3. John Howard, The State of the Prisons in England and Wales 2nd. Ed. (Warrington: T. Cadell 1780) 430–31.

4. Thomas Taylor, Memoirs of John Howard (London: John Hatchard, 1836) 386–87.

5. Gabriel Cervantes and Dahlia Porter, “Extreme Empiricism: John Howard, Poetry, and the Thermometrics of Reform,” The Eighteenth Century, 57:1 (Spring 2016): 97.

6. William Hayley, “Ode, Inscribed to John Howard” (Boston: J. White et. al. 1795 [1780]).

7. George Romney, John Howard Visiting a Prison or a Lazaretto, 1790–95, courtesy of the Museum of Fine Arts, Boston, MA.

8. John Aikin, A View of the Life, Travels, and Philanthropic Labours of the Late John Howard (Boston: J. White et. al., 1794) 120–25.

9. William Hepworth Dixon, John Howard and the Prison World of Europe, 2nd ed. (London: Jackson and Walford, 1850) 1.

10. Robin Evans, The Fabrication of Virtue: English Prison Architecture 1750–1840 (London: Cambridge UP, 1982) 104–114; Michael Ignatieff, A Just Measure of Pain (London: Penguin, 1978) 3–14.

11. Gilbert Blane, “Letter to John Hippisley,” in Observations on the Diseases of Seamen (London: 1799): 614–15.

This entry was posted in Collections, Events, guest post, History of medicine, History of public health, Uncategorized by nyamhistory. Bookmark the permalink.

About nyamhistory

The Center for the History of Medicine and Public Health, part of the Academy Library, promotes the scholarly and public understanding of the history of medicine and public health. Established in 2012, the Center aims to build bridges among an interdisciplinary community of scholars, educators, clinicians, curators, and the general public. The Center bases its work on the Library's historical collections, among the largest in this field in the United States and open to the public since 1878.

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