It is perhaps difficult to imagine Malton without a system of sewage disposal, without drains and without a water supply other than pumps around the town. However a report in 1854, focuses on the then 'Sewerage, drainage, and supply of water, and the sanitary conditions of the inhabitants of the parliamentary borough of Malton' 
The inspector making the report concludes that the rate of mortality is excessive, that there is neither efficient sewage nor drainage; that their are many nuisances dangerous to health; that there is no public water supply; that there are covered cesspools attached to houses and that here are many nuisances arising from open cesspools, exposed middens, and from foul pigsties; that there are nuisances arising from slaughter-houses; that roads and lanes are unpaved; that many yards and courts are constructed so as to block out sunshine and fresh air; that many houses and rooms are most imperfectly ventilated so as to induce disease in excess; that preventable disease (fever) is common, and that the mortality from such disease is excessive and costly.
The recommendation of the report was to apply the Public Health Act 1848 to the parliamentary borough of New Malton and in consequence a Local Board of Health be created.
 Yorkshire Gazette, 15 July 1854
On Wednesday 21 September 1853 the streets of Malton were placarded with notices calling on residents of the town to remove any nuisances which might arise on their premises. In response to the Nuisances Removal and Diseases Prevention Act, the guardians had appointed Dr. Francis Borton medical inspector of nuisances. Hand-bills were also distributed inviting anyone with knowledge of a nuisance to report it to Dr. Borton  Joseph Rowlandson, tripe boiler, was summoned by the guardians of the Malton Union, for a nuisance caused by his keeping pigs on his premises. He pleaded guilty and promised to refrain in future .
 York Herald, 24 September 1853
 Yorkshire Gazette, 21 October 1854
Local boards of health assumed responsibility for street cleansing, paving, sewers and the slaughter-house. They appointed a treasurer, clerk, officer of health, surveyor and inspector of nuisances.
The legal creation of the Malton Local Board of Health is documented in issue 6437 of the Edinburgh Gazette, page 955 'The first election of said Local Board of Health should take place on the first day of November, in the year of our Lord one thousand eight hundred and fifty-four. At the first election, William Charles Copperthwaite, of The Lodge, Malton, was granted powers to perform all duties to ensure completion of the first elections.
The Malton Local Board of Health was abolished by the Local Government Act 1894 and became Malton Urban District Council.
It was at the top of Saville Street close to the junction with the Market Place (Ordnance Survey map 1850), and was a predecessor of the Cottage Hospital. Newspapers carried summaries of the quarterly reports.
InJanuary 1837, the physicians were said to be Dr. Travis and Dr. Borton, the surgeons Messrs Teasdale, Pratt and Colby, and the apothecary Mr Joshua Hartley - York Herald, 7 January 1837
A further newspaper report summarised the work of the Malton Dispensary since the commencement of the charity in March 1835 to the 1st January 1839. The number of patients admitted was 1,458 of which 620 were admitted during 1838, and 122 remained on the books. 
The annual meeting of subscribers to the Malton Dispensary held in January 1838 reported that ‘Patients admitted since the establishment in 1832, 2,294’  – the same meeting reported the numbers of admissions, discharged, deaths, cured etc for 1837 together with a summary of the accounts, including an amount of £30 17s 6d spent on ‘drugs and leeches.’ Late in 1831 the Leeds Intelligencer carried an advertisement for an Apothecary 'Salary £50 per annum, with rooms at the Dispensary, Coals and Candles' .
One example for the quarter 1st January to 31st March 1842 told readers ‘Remaining at the last quarterly report, 42; admitted out-patients, 67; visited at their own home, 44; total 153. Discharged cured, 57; relieved, 9; time expired 23; dead, 5; remaining under treatment, 59.’ The report continues to give the names of the staff: ‘Physicians Dr. Travis and Dr. Boston; Surgeons – Messrs. Rymer and Teesdale; Apothecary – Mr. R. Meggison.’
There was a hint at the state of the finances of the Dispensary when in March 1854 a meeting was held at the Malton Institution on Friday March 24th of Subscribers to the Malton Dispensary. The aim was to derive means of placing the charity on a better footing following a report delivered by a committee appointed to investigate their affairs. Various economical suggestions were put forward and implemented to improve the financial state of the charity and to help self fund it a decision was made to charge adults 1/- and children under twelve 6d on presenting the ticket at the dispensary  The Dispensary appears to have been funded by donations and subscriptions. A popular supporter being a Mr. Aspland who ran a steam ‘switchback’ or mountain railway in the Market Place and made generous donations . Early in 1895 a meeting was held to discuss the idea of Malton having a ‘Cottage Hospital’  However, a year later, at the annual meeting of subscribers to the Malton Dispensary it was reported that ‘insufficient promises of support to the scheme of providing a new hospital had led the committee to suggest, as an alternative, that the present dispensary be re-arranged so as to provide a temporary accident ward ....’ 
 York Herald, 26 January 1839
 York Herald, 10 February 1838
 Leeds Intelligencer, 29 December 1831
 Yorkshire Gazette, 9 April 1842
 The Malton Messenger, 1 April 1854
 Yorkshire Gazette, 6 June 1891 and 24 November 1894
 York Herald, 14 January 1895
 Yorkshire Gazette, 7 March 1896
The Malton Cottage Hospital was opened by Countess Fitzwilliam on Friday 18th August, 1905 Prior to this time, in cases of serious injury, persons had to be conveyed to York before their injuries could be properly attended to. The building was previously known as Mount Pleasant and was situated off Greengage. It was let to the Committee by Earl Fitzwilliam at a nominal rent. It had an operating theatre, electric light installed as well as gas - one signatory commenting ‘that it compared very favourably with the streets of Malton at the present time’. It also had a mens ward and a women ward each with two beds, a spare room easily convertible into a third ward of two beds, plus matrons room, kitchen and bedroom with a laundry in the basement. The funding came from donations and a subscription. The first matron was a Miss Lloyd who came from the Royal Chest Hospital, London. 
 Malton Gazette, 26 August 1905
The Apothecaries Act of 1815 defined a requirement for apprenticeship and qualifications. This allowed apothecaries in early Victorian times to prepare and prescribe medicines and give medical advice. They performed a role closer to that of a general practitioner today. Before the end of the Victorian period the medical profession had however evolved into constituent parts such as chemists and druggists, surgeons and physicians. The Medical Act of 1858 formalised the qualifications required for the profession.
William Willey was an apothecary in Malton in the late 18th century as stated in the death announcement of his wife  The Worshipful Society of Apothecaries granted certificates of qualification to the following, of Malton:
1834 Thomas Cobb 
1834 Alfred Temple 
1839 Frederick le Fevre 
1850 Joshua Hartley 
1851 William Taylor Colby 
1852 James Atkinson 
(this list not exhaustive)
 Leeds Intelligencer, 10 June 1788
 London Standard, 2 May 1834
 London Standard, 6 October 1834
 London Standard, 9 August 1839
 London Standard, 18 October 1850
 London Standard, 27 June 1851
 London Standard, 25 June 1852
The following has been drawn from newspapers and censuses:
Mr G. Bartliff, who was in need of a 'Visiting and Dispensing Assistant' stating that 'none need apply who are not quite competent to attend Midwifery' 
Mr Pratt, who died on Tuesday, 10th March, 1840, aged 64 
Mr Joshua Hartley, who gave his views to the Newcastle Chronicle on the case of Mrs Fred Williams, of Malton, and who was pronounced dead but whose family believed she was in a trance 
Mr Robert Sagg, whose daughter Mary married a Mr. Rowley at Deptford in 1821 
Mr Robert Wilson, who in 1808 died on board the Elizabeth, a Greenland ship, whilst entering the harbour at Hull, aged 49 - 'he had been indisposed during a great part of the voyage home .
A short article, written by John Willmott, about the Hartley medical family (two generations of Malton doctors) can be seen here.
 Yorkshire Gazette, 29 January 1842
 Yorkshire Gazette, 14 March 1840
 Western Daily Press, 15 November 1877
 Yorkshire Gazette, 8 September 1821
 York Herald, 20 August 1808
Dentistry in early Victorian times consisted of extractions and false teeth. There was no formal dentistry qualification and many barbers would provide tooth extraction as an additional service. In 1841, Mr. Mosely described himself as a 'surgeon-dentist', and visited Malton in private apartments at the Talbot Inn, every other Friday and Saturday. He promoted 'Newly Invented Mineral Teeth' which were 'Fixed without Ligatures, or any other injurious attachment whatever, from One to a complete set on a Principle so certain that Mastication, External Appearance, and Articulation are astonishingly restored and guaranteed to the patient' . Mr. Mosely was still in business in 1845, visiting the Talbot Hotel every Saturday . Mr. R. Parsons, also surgeon-dentist attended the Talbot Hotel on the last Saturday of every month . The 1871 Census shows Thomas J. Blanche, dentist, living in Yorkersgate with his family. He is still there in the 1891 Census. In 1889, Ruth Richardson, servant to Thomas Blanche, pleaded guilty to stealing linen and other articles from her employer and was sent to gaol for one month . Mr. Blanche was clearly successful with his business as in August 1888 he was the successful bidder for shares in the Malton Gas Company and also the Gas Company in Scarborough .
Mr. Blanche also instigated a series of charity concerts, inviting the gentry of the area. The first of these was in 1870 for the poor of Malton and repeated in 1871 for the poor of Norton - 'On Tuesday night one of the most aristocratic gatherings ever got together in Malton assembled at the Subscription Room. … Somewhere about 850 ladies and gentlemen attended, and the receipts will be about £50' .
 Yorkshire Gazette, 27 March 1841
 Yorkshire Gazette, 17 May 1845
 Yorkshire Gazette, 22 February 1845
 Northern Echo, 13 May 1889
 York Herald, 11 August 1888
 York Herald, 18 February 1871
Due to the crowded and insanitary conditions in the town there were instances of cholera. One family fell victim and all 3 had died within 3 days in 1849: Same day (17th August), at New Malton, aged 46, Elizabeth, wife of Mr. David Oxendale, after suffering from spasmodic cholera, 30 hours; on the 18th inst., at the cholera hospital, Malton, aged 2½ years, from spasmodic cholera and consecutive fever, Rebecca, daughter of the above David and Elizabeth Oxendale; and on the 19th inst., at the above hospital, aged 26, the above named David Oxendale, after suffering from diarrhoea 18 hours, and from Asiatic cholera ’ The coroner’s inquest concluded that the wife and daughter had ‘died from cholera brought on from want of sufficient food, through the neglect of David Oxendale, husband to the above’ 
On the 21st August Samuel Walker, Clerk to the Malton Union Committee of Health issued a notice in The Messenger regarding the recurrence of Cholera in various places throughout the country. They requested that householders would remove any nuisances from their premises and to check the state of drains, privies, ashpits, cesspools and piggeries to make sure they were in good order. They were also instructed to whitewash their dwellings with lime and to improve ventilation where possible. It was felt that these measures would prevent or check the progress of cholera and other diseases from spreading. 
An order of precautions against Cholera from Samuel Walker, Clerk to the Malton Union Committee of Health was published in the Malton Messenger in October 1854. The General Board of Health issued these warnings: 1. Apply for medicine to stop loose bowels as it may bring on Cholera. 2. Do not take any Strong Opening Medicine without medical advice. 3. Excess in alcohol is likely to be followed by Cholera. 4. Only drink boiled water that is clear and tastes well. 5. Don’t eat tainted or decayed meat, stale fish or raw vegetables and eat cooked vegetables and fruit in moderation. 6. Avoid fasting and be moderate at meals. 7. Avoid great fatigue and being heated and then chilled. 8. Avoid getting wet and remaining in wet clothes. 9. Keep your body and feet clean, dry and as warm as your means and occupation allows. 10. Clean and lime wash your rooms removing any dirt or impurities. 11. Open your windows as much as possible and remove any offensive smells with chloride, lime or zinc. 12. If you know of any dust or dirt heaps, foul drains or smells or any other nuisance in your house or neighbourhood report immediately to the Board of Guardians, Committee of Health, or to the Relieving Officers of the Union 
 York Herald, 25 August 1849.
 Yorkshire Gazette, 25 August 1849
 Malton Messenger, 2 September 1854
 Malton Messenger, 5 October 1854
Towards the end of 1871 rumours were rife of a serious outbreak of smallpox in the town  ‘the wildest and most unfounded rumours were afloat, and to such an extent that some people gave their orders at shop doors, and positively objected to enter houses, and others coming by train refused to leave the railway station, and sent for their goods from the town.’ An outbreak had occurred, but on a much smaller than imagined scale. A boy infected by the disease, arrived by train from Scarbro’ on 18th November 1871, and died on 23rd November, being buried the next day. Around 40 cases subsequently occurred; all were traced back to the single case. By late February it was reported that due to the rumours the trade of the town had greatly suffered and ‘Returns from the medical men show that out of a population of 8,000, 210 cases have occurred, and 36 deaths’  The first quarter of 1872 recorded 31 deaths in the Malton Union from small-pox and concluded ‘The health of the town greatly improved during March, only two deaths from small-pox having occurred throughout the district’  The Board of Health meeting on 26 June 1872 ordered ‘that a sum of £24 be devoted for gratuities to the board’s inspector, and others for extra services rendered during the recent epidemic of small-pox ...’
 York Herald, 23 December 1871
 York Herald, 2 March 1872
 York Herald, 6 April 1872
 York Herald, 29 June 1872
Would you believe there were riots in the Malton streets over demands to have children vaccinated against smallpox? Smallpox was a prevalent disease throughout the Victorian era but despite government attempts to encourage parents to have their children vaccinated the uptake was low. A series of Vaccination Acts introduced increasingly stringent provisions around vaccination and how this was to be enforced. The usual practice was to vaccinate a child and then, if the child was well at an examination eight days later, to take lymph from the vesicles on their arms with which to vaccinate other children. Some parents objected to having their children vaccinated on religious grounds, while others felt that smallpox vaccination caused more illness than it prevented.
The local Boards of Guardians (which looked after health and some other matters in each area) had to prosecute parents who did not have their children vaccinated. Any unpaid fines would lead to imprisonment or to the seizure and sale of their personal possessions. The process would then be repeated until the person complied. The strength of feeling against vaccination appears to have been high in Malton. An Anti-Compulsory Vaccination Society was formed in the town (York Herald 14 February 1874.) Little seems to have been reported about the conduct of these meetings and their propaganda efforts but in the The Malton Gazette, Saturday, July 8th, 1876, there is a report covering The Vaccination Question - Extraordinary Proceedings at Malton A further response to the several prosecutions instituted by the Board of Guardians was a letter being ‘ ... sent to one of the local magistrates, in which the writer threatens to take his life if he convicts in any further prosecution of non-vaccination’ (York Herald 4 September 1875.)
At a public meeting held in the Spittle-street school on Tuesday, 27 March 1877, a Malton branch of the AntiVaccination League was formed. Membership was 1s. Mr. J. Appleby was appointed president and Mr. Edwin Hall (photographer), secretary .
Mr. Rawling, cordwainer, of Malton, was sent to Northallerton Gaol for seven days for refusing to comply with the law. On his return, thousands lined the streets from the railway station to the Market place where a meeting took place and the boisterous gathering broke windows at the town hall (Sheffield and Rotherham Independent, 2 October 1876.) The Vaccination Act of 1898 allowed parents to register their conscientious objection to vaccination. The Yorkshire Evening Post of Monday September 19th 1898 reports that 'The Malton Guardians have resolved, in consequence of the passing of the Vaccination Act, to give up the vaccination stations in the Union.'
 York Herald, 31 March 1877
These are different diseases and it may be that historical references, for example in the local newspapers, are inaccurate. Typhoid is generally caused by a bacteria called Salmonella typhi and can be spread through faeces. Those drinking water or food contaminated with the bacteria stand a very good chance of contracting typhoid. Complications include internal bleeding and the splitting of intestine and bowel with consequent widespread infection. By contrast, Typhus is a bacteria disease spread by lice and fleas and can pass from rats to fleas to humans. It can be imagined that where there are crowded and insanitary conditions both these diseases can take their toll.
Local press death announcements may give cause of death - September the 17th, at New Malton, of typhus fever, Sarah Ann Loftus, aged 21  and hint at the spread of these diseases - Same day (the 5th) at New Malton, of typhus fever, aged 27, Hannah Peckett, cook to William Simpson, Esq., of that town,solicitor. On the 28th ult., at New Malton, of typhus fever, aged 22, Mary Ann Peckett, servant, sister to the above Hannah Peckett 
 Hull Packet, 29 September 1848
 York Herald, 8 February 1851
The influenza epidemic may be said to have reached its crisis during the week-end so far as Malton was concerned … … The outbreak with its serious consequences highly increased the death rate, and more funerals took place in Malton and Norton in one week than was ever known before… … Several pathetic instances have occurred. The death of Misses synan within a few hours of each other has created the greatest sympathy. In another case a Malton soldier arrived home on leave to find his wife had passed away an hour or two previously… … the difficulties of labour spread to the Malton Gas Works, and on Friday and Saturday the gas supply gave out, and both Malton and Norton were in darkness. Business had to be carried on with lamps and candles, and on Sunday the evening services had to be cancelled, being held in most instances, in the afternoon… … This is the first time since the flood of 1878 that the gas supply has failed.
Malton Messenger, 16 November 1918
On 24th October, 1932 typhoid fever broke out at Malton. There were 270 cases, 23 proving fatal. Many events were abandoned owing to the epidemic and the town was practically deserted, people refraining from visiting the town and residents living in fear behind closed doors. A relief fund was set up. A government inquiry found that the epidemic started when a patient was admitted to the Workhouse with a severe fever, later found to be typhoid. His use of the lavatory led to contaminated water entering the soil via a cracked drain, which had been accidentally ruptured with a pickaxe. From the soil the infection soon reached the town's well, the sole public water supply. One Malton G.P., Dr Parkin worked day and night to combat the infection, and his dedication almost certainly saved the lives of many. He died on December 3rd, his fourth wedding anniversary, becoming victim 20. At his funeral weeping crowds lined the streets and several thousands gathered in the market place for a service. The Gazette of 12th June 1964 compares the typhoid outbreak in Malton (270 cases, 23 deaths, less than 5,000 population) with an outbreak in Aberdeen (400 cases, 1 death, population 298,000). During the outbreak, Malton people working in other districts were dismissed or suspended by their employers. In 1932 the public water supply came from the Ladywell, about 300 yards east of the workhouse at the bottom of Castlegate. The district council had been urged to abandon this supply 40 years earlier because it was liable to pollution due to the periodic flooding of the Derwent, into which the town's untreated sewage was discharged. Interestingly, when the local surveyor observed the flood water in the Derwent reaching a certain level he would stop pumping from the well! The man with the initial infection was admitted to the workhouse on 23rd September. It was not until 24th October that townspeople, via the town crier, were told to boil all water until further notice. At that point, 20 cases had been reported in three days. The Yorkshire Gazette reported regularly on the progress of the epidemic, naming those who had succumbed to the infection, the hospital they were in and the status of their condition. On 28th October 1932, 60 cases were reported and by 25th November 245. The edition of 11th November hints at the seriousness, quoting the librarian at Malton "All books returned from infected houses are being burnt," and, a Malton ambulance driver who took a patient to Leeds as being refused assistance when the ambulance had broken down as the vehicle had been employed on typhoid cases. "A United Service of Thanksgiving and Remembrance" was held at St. Michael's Church, on 23rd April 1933. The service booklet listed the following as the victims of the epidemic: Louisa Richardson, Alice Ann Sedman, Doreen Standing, Peter Noel Hick, John Wm. Pounder, Roy K. Packwood, Arthur Barker, Mary Heseltine Blades, Violet Baker, Mary Berriman, Gladys Berriman, Evelyn Bannister, Thomas Churchman, David Nendick, George Colley Parkin, Matilda Miles, Olga Humphrey, Irene Lythe, Bertha Newey, Martha Lapish, Sydney Dent Bowman, Peggy Bradshaw, Doris Smith, Dorothy Barnes, Annie Boggitt.
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