A patient undergoing treatment for tuberculosis at the Municipal Sanitarium, Chicago, Illinois, 1941. A doctor and a nurse stand over a patient who is lying on a treatment table in a medical facility. A chest x-ray is hanging from the wall.
24 April 2022
Today, we associate sanitary and sanitation with cleanliness, refuse collection, and sewer systems. But it was not always that way. Originally, these words referred to health and medicine, especially to public health measures and disease control. These are modern words, coined in the early nineteenth century from the classical Latin noun sanitas, meaning health, and the medieval Latin verb sanare, meaning to heal or cure. Over time, however, the meaning of sanitary and sanitation have specialized, usually referring to cleanliness, which is just one aspect of disease control. Likewise, the word sanitorium, or sanitarium, originally just meant hospital. Over time the meaning of that word also narrowed to refer to a place that specialized in the treatment of a particular affliction or range of afflictions. Sanitoriums became hospitals for those with tuberculosis or with mental illness.
The adjective sanitary is recorded in 1806, referring to quarantine regulations intended to control the spread of the plague. We see it in an 1806 English translation of Paolo Assalini’s description of the plague in Egypt:
When the Franks residing in Egypt are assured that the plague has broken out in the place where they live, they retire into their houses, shutting all their doors, and having no intercourse with any one until the 23d of June, the eve of St. John. Not only are their doors closely shut, but they block up with care even the smallest holes, in order to prevent any animal entering their dwelling; and if by chance a cat should creep in, they immediately pursue and kill it. For this purpose they have loaded muskets always in readiness, and springs set in the suspected parts of the house. The cats of the family are shut up in cages, like fowls; and if, unfortunately for them, they chance to leave their prison, and make their escape, on their return they are killed without mercy, according to the sanitary laws; in case they should, during their absence, have contracted the poison of the plague, and brought it home attached to their tail, or hair of their skin.
Sanitation appears by 1826 in the context of quarantining ships prior to their entry into a port. A lengthy article critiquing the British government’s quarantine policy was published that year. It’s a rather remarkable piece when read today in that it encapsulates many of the objections to present-day measures to control the spread of Covid. It opines that the regulations are overly burdensome to trade and commerce, and it accuses the government bureaucrats of being “cosmopolite” elites:
This invaluable trade, as an object of English benefit, which only required our liberal and enlightened ministers to let it alone, if they would not encourage it, has been almost annihilated, or at least rendered so unproductive to the ship-owner, as not to be worth carrying on; and how, it may be asked, has this been effected? Why by the aid and operation of the quarantine laws—a code of laws and regulations which, if contagion could be introduced into this climate, would insure its admission; but even the laws themselves are emanations of light and good sense, as compared with the intolerable mode of enforcing them, by the cosmopolite imbeciles, who have the direction of their administration.
It is obvious that Liverpool must be the great entrepot of the cotton imported into England, from its local position as to the consumption. Taking it for granted, then, that the quarantine is necessary, as this is not a place to discuss that subject, it obviously became the duty of the government to ascertain where and how the ships could be placed so as to perform this performance in the safest and least expensive way to themselves and cargoes. Now, a reference to the map would have shewn them one of the noblest estuaries in England, in which ten times the number of ships could ever by any possibility be congregated for the purpose of this legal sanitation, might be moored with perfect safety within a distance of three miles from the place of their final discharge.
And the next year, 1827, we see mention in a Bury St. Edmonds newspaper of a hospital bearing the name of Sanitarium that was established in India:
A very excellent Institution has been opened at Calcutta by the Bengal Government. It is called the Sanitarium, and it is intended for the accommodation of Officers repairing to the Presidency on sick certificate. It is placed under the charge of one of the Company’s Surgeons, who is also directed to afford medical aid to all Officers of the General Staff of his Majesty’s and the Hon. Company’s service at the Presidency, and to all officers and European soldiers residing out of, and not attached to, the garrison of Fort William.
The older, more general sense of these words meaning health is rarely encountered nowadays. Sanitation and sanitary are almost always references to cleanliness and control of pests and vermin, and sanitorium almost always refers to a mental health facility. But one can still find the general sense in jargon, especially in legislation, regulations, and in the fossilized names of sanitary commissions and the like. And still, the primary reason for undertaking even the narrower cleanliness measures encompassed by sanitation is to control the spread of disease.
Sources:
Assalini, Paolo. Observations on the Disease Called the Plague. Translated by Adam Neale. New York: T & J. Swords, 1806, 73–74. Gale Primary Sources: Sabin Americana: History of the Americas, 1500–1926.
Dictionary of Medieval Latin from British Sources. Oxford: Oxford UP, 2013, s.v. sanare, v. Brepols: Database of Latin Dictionaries.
Lewis, Charlton T. and Charles Short. A Latin Dictionary. Oxford: Oxford UP, 1879, s.v. sanitas, n. Brepols: Database of Latin Dictionaries.
Observations, Addressed to the Shipping, the Agricultural, and the Commercial Interests on the Impolicy of the Free Trade System Pursued by his Majesty’s Ministers. (25 July 1826). Newcastle, England: Edward Walker, 1826, 6. Gale Primary Sources: The Making of the Modern World.
Oxford English Dictionary, second edition, 1989, s.v. sanitary, adj., sanitation, n., sanatorium, n., sanitarium, n.
“Sunday’s Post.” Bury and Norwich Post (Bury St. Edmonds, England), 12 December 1827, 1. Gale Primary Sources: British Library Newspapers.
Image credit: Lee Russell, 1941. Library of Congress, Farm Security Administration—Office of War Information Photograph Collection. Public domain photo.