Hygeia: a healthy city

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“Hell is a city,” wrote the poet Shelley. And countless city dwellers, from the inhabitants of ancient Athens, battling plague, to the residents of 21st century Toronto, barricading themselves against severe acute respiratory syndrome, would agree. Ever since the first clustering of humans into tightly knit communities unleashed waves of infectious diseases, citizens have bemoaned their urban environment.

Yet the idea of a healthy city is not just a utopian dream. Or so the physician and public health reformer Benjamin Ward Richardson (1828-96) insisted when he unveiled his vision of Hygeia, a City of Health to the Social Science Association in 1875.

Impelled to a career in medicine by the dying wish of his mother, Richardson qualified in 1854, the same year he moved to London—that “Great Wen”—where he worked in several city hospitals. In the typical mode of a Victorian polymath, Richardson became an eminent anaesthetist who developed no fewer than 14 new anaesthetics; was a dedicated supporter of the sanitary movement who founded the first public health journal; and was a prolific writer of poetry and drama, a keen cyclist, and an ardent temperance campaigner.

Eager to bring his undoubted talents to designing a model city, Richardson was convinced that contemporary scientific knowledge could create “a working community in which death . . . is kept as nearly as possible in its proper or natural place in the scheme of life.”

Spacious, green, and clean, Richardson’s Hygeia would comprise a population of 100 000 living in 20 000 houses arranged on a grid pattern of wide, quiet streets. Railways running under each of the three main thoroughfares keep traffic to a minimum. The roads are built of wood set in asphalt to render them “noiseless, clean, and durable” and bordered by broad pavements. Buildings are limited to four storeys to ensure maximum sunlight; and greenery abounds, with tree lined streets, public squares, and a garden behind every house.

Hygeia’s houses are roomy, well ventilated, properly heated, and easily cleaned and boast hot and cold running water with efficient sewerage systems. The happy Hygeians enjoy plentiful public laundries, libraries, schools, swimming pools, and centres for “instructive amusement.” Alcohol and smoking are effectively banned, and brothels and gambling dens are absent. Elderly and mentally ill residents are cared for in houses no different from the norm, and work is available for all able bodied citizens.

A model city naturally contains model hospitals for the sick. Each would serve a catchment area of 5000 people and would have lofty, glassed entrance halls and single sex wards that lead on to verandas and gardens. “To make these institutions the best of their kind, no expense is spared,” Richardson explained, and the outpatient departments would run so efficiently “that a sick person, who is punctual to time, has never to wait.”

Although Richardson had to admit that his city of health was “as yet unknown,” he was adamant that the knowledge and technology to make his dream a reality already existed. “Utopia itself is but another word for time,” he mused. Though more than a century after Richardson’s death, modern dictionaries prefer the definition “an imaginary place.”