Ideas: A History from Fire to Freud

Suicide is his best-known book. On the face of it, as Roger Smith says, this does not appear to be a sociological

topic.⁴³ It is nothing if not intimate, private, subjective (Gide was later to argue that suicide is in principle inexplicable). But that was Durkheim’s point: to show that psychology had a sociological dimension. In the first part of his book, he used statistics to show that suicide rates varied, for example, according to whether someone was Protestant or Catholic, whether they lived in the countryside or in the town. This had never been done before and people were shocked by his findings. But Durkheim himself was not satisfied with these more obvious variables. He also thought that less tangible social features were just as important, and he divided suicides into egoistic, altruistic, anomic and fatalistic. ‘Egoism’ he described as ‘a measure of a society’s failure to become the focus of the individual’s sentiments’.⁴⁴

In a society where such failures show themselves, a high proportion of people are aimless and ‘unintegrated’. ‘Anomie’ he defined as a general measure of a society’s lack of norms, which mean that many people lead unregulated lives, with numerous side-effects such as high crime. Durkheim was arguing, therefore, that there is such a thing as society, that there are

social phenomena – egoism, anomie – that in a sense exist outside individuals and cannot be reduced to biology or psychology.⁴⁵

Another of Durkheim’s achievements, in making the case for a sociological approach to human behaviour, was that he also laid the groundwork for sociological medicine, what we now call epidemiology. He wasn’t the only one of course – the German states, Austria and Sweden had all begun to collect data for this purpose in the eighteenth century. But social medicine, epidemiology, was also born in the great industrial cities as people struggled to cope with unprecedented problems and experiences, not least in regard to hygiene. One of the first in Britain, who scored a notable early success, and acted as a model for others, was Sir John Snow, who took a statistical/sociological approach to cholera. In 1854, there was in London a terrible outbreak of cholera which had caused over five hundred deaths in fewer than ten days. In going through the lists of deceased and afflicted persons, Snow noted that most cases had occurred in the neighbourhood of Broad Street. ‘Upon interviewing members of the families of the deceased, Snow was able to isolate a single common factor, namely the Broad Street [water] pump, from which victims had drunk in every case. Corroborating evidence was made from the observation that in the local workhouse, also in the Broad Street area, only a few inmates had contracted cholera and that in every case they had contracted it before being admitted to the workhouse. Snow hypothesised (and found) that the workhouse drew water from a separate well . . . The pay-off for Snow’s careful investigation occurred when, finally convinced that impure water from the Broad Street pump was the cause of the cholera, Snow appealed to the authorities to have the pump closed.’ This brought the outbreak to an end. Though it had little immediate effect, the episode subsequently became a legend. What makes the investigation doubly unusual is the fact that the cholera bacillus was not discovered, by Robert Koch, until some twenty-eight years after Snow’s investigation.⁴⁶

The germ theory of disease did not emerge fully until the 1880s. At much the same time that Snow made his deductions, Ignaz Semmelweis, a Hungarian, observed that cases of childbed fever could be reduced by having surgeons wash their hands between deliveries. Joseph Lister went further in 1865, advocating the use of carbolic acid (phenol) on patients’ wounds during surgery. But it was not until Louis Pasteur noticed that weakened bacteria could be used to provide immunity from diseases they provoked at full strength, that the idea of vaccination was conceived and quickly used for a widening number of ailments which proliferated in cities – tuberculosis, diptheria, cholera.⁴⁷

The problems of urbanisation also prompted the British to establish a decennial census, beginning in 1851. The aim here was to provide a simple but empirical basis for the social dimensions of modern Britain. In turn, the census stimulated the first systematic attempts to assess the dimensions of poverty and of the housing problem. This, says Roger Smith, ‘transformed the political and moral consciousness of the country’.⁴⁸