Local studies have much to contribute to the study of the history of public health reform in nineteenth-century Britain. They may help elucidate the shifting margins between competition and complementarity in the efforts of local and national government. They can offer a corrective to hasty generalization from narrow, usually London-based, sources. They throw light upon the implementation of legislation and upon the local negotiation of the ideas and strategies of medical and political elites. It is equally important, however, that local studies remain aware of the national context of the issues being examined. Otherwise, the specific significance of the local study will be lost.