The obituarist in the Edinburgh Medical Journal of 1859 praised the Edinburgh physician, and reformer William Pulteney Alison as a “devoted and trusted friend of the poor.” Alison’s background was far removed from the experience of most of his patients. His father was a popular clergyman and his mother was a member of an influential medical family—the Gregories. Alison’s education included fashionable, continental tours during which he enjoyed climbing mountains—including Mont Blanc. After graduating in 1811, Alison had a distinguished medical career that included two Edinburgh University professorships and the presidency of the Royal College of Physicians of Edinburgh.

However, Alison had radical leanings and as a physician practising from the Edinburgh New Town Dispensary he was well aware of the terrible living conditions that existed in parts of 19th century Edinburgh. Published in 1840 (after his dispensary experiences) Alison’s great work Observations on the Management of the Poor in Scotland and its Effects on the Health of Great towns contains a well argued attack on the governing classes and civil institutions of Scotland. Alison felt that establishment preconceptions had resulted in the gross neglect of the interests of the poor and destitute. By using statistical evidence Alison showed, in his clearly written book, that poor relief should not just be provided for the sick but that it should be spread much wider. He argued that the state had a central role—not the private and religious charities that were the main Scottish providers of the time. Alison’s proposals included aid for widows and orphans and for the unemployed able bodied poor. He suggested a unified system of workhouses and fever hospitals. Compulsory taxation would fund his initiatives. After much controversy the reforming Royal Commission of 1844 supported many of Alison’s views. Poor health marred the last years of Alison’s life but he lived to see public opinion shift some way towards his ideas.