Focusing on the figure of William Gaskell, husband of Elizabeth, dissenting minister, reformist, and poet, this chapter discusses how the literature of ‘social problems’ interacted with the emerging field of sanitary science. The city of Manchester and the working-class family periodical are examples of ferments where ideas on what constitutes knowledge of questions relating to poverty and poor sanitation are channelled through an intricate relationship shared by medicine, reportage, and fiction. The poems of William Gaskell are read alongside the sanitary work of Thomas Southwood Smith. Both men contributed to the radical Howitt’s Magazine and both sought to reframe the social project in such a way that an analysis of the very means of knowing could underpin the representation of urban health problems. This was an epistemological strategy, and insight, that came about through the intersections of medicine and literature – through their shared spaces, vocabularies, and means of representation.