One of the most significant movements to arise and gain momentum within the nineteenth century was the movement towards reform in public health and sanitation. This great sweeping movement aimed to reform most aspects of life so that the health and lives of entire populations could be improved by sanitary science. In this way, sanitary reform can very much be seen as a humanitarian act aimed to improve lives. However, in other instances reform in public health and sanitation was not motivated by such humanitarian motives and could often be self serving. In the case of India, reform in public health and sanitation, at least during the nineteenth century can often be seen as an example of both of these positions. Even those reformers like Florence Nightingale who wished to see the health of India’s people improved also regularly stressed the importance of improving health to maintain an army capable of impressing military control upon India. The movement to extend the benefits of sanitary science beyond Europe and onto subject colonies in this way begins on morally ambiguous grounds. Whether sanitary science was used as a tool of empire or a tool for the betterment of mankind is certainly a subject for debate. However, the nature of sanitary reform in the Madras Presidency reveals some of the serious limitations which public health reforms faced in India. This thesis examines the manner in which the application of reform differed along racial lines and between military and civil populations. This analysis reveals, to some extent, the priorities of the colonial government and the clashes between official sanitary policy and expenditure and sanitary reform as it occurred.