FROM FEVER TO DIGESTIVE DISEASE: APPROACHES TO THE PROBLEM OF FACTORY ILL-HEALTH IN BRITAIN, 1784-1833 by CARLA SUSAN PATERSON B.A., The University of British Columbia, 1977 M.Sc., The University of Sussex, 1978 A THESIS SUBMITFED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE STUDIES (Department of History) We acceptbis thesis as conforming to tHe req red standard: THE October 1995 © Carla Susan Paterson, 1995 _______________ _______________ K., In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. (Signature) Department of The University of British Columbia Vancouver,.Canada Date iA5’ DE-6 (2188) —11— ABSTRACT In the early decades of British industrialization, the ill-health of textile factory workers attracted considerable public interest and provoked discussion and debate among a growing number of medical men, operatives, manufacturers, and social and political commentators. Guided by previous studies of the “framing” of disease, this dissertation examines how such ill-health was conceived, designated and responded to in the period from 1784 to 1833. The dissertation reveals that workers themselves held a relatively constant view of their condition. In the early part of the nineteenth century, they drew attention to a variety of ailments and throughout the period they saw a clear link between their maladies and the conditions of their labour. By contrast, medical understanding shifted significantly, and as it traced a course more or less at odds with that of popular comprehension, the nature and causes of worker suffering were substantially redefined. In the 1780s and 1790s, doctors identified the illness of factory labourers as “low, nervous fever,” an acute contagious disorder generated by the crowding and confinement of human bodies. A generation later, in the period from 1815 to 1819, the ill-health of mill workers was conceptualized, by a portion of the medical community, as “debility,” a poorly-understood state of constitutional feebleness attributed to aspects of machine work. In the early 1 830s, medical authorities regarded factory workers’ sickness primarily as “digestive disease” and located its source in habits and diet. The reconceptualization of worker ill-health yielded an ultimately optimistic —111— assessment of the consequences of industrial growth, failing to offer strong support to demands for legislative restriction of factory operation. It also served to sanction changing social relations through providing evidence of the physical and moral distinctness of the manufacturing population. As medical theory altered, so, too, did practices of relief and assistance. While mill owners, and doctors, became increasingly unwilling to assume responsibility for the well-being of the industrial workforce, operatives engaged ever more extensively in practices of self-help. The expansion of the textile industry, however, ensured the continuation of their affliction and incapacity. -iv- TABLE OF CONTENTS Abstract ii Table of Contents iv List of Tables V Acknowledgement vi Introduction 1 Chapter One Fever and Factories 16 Chapter Two Contagion in the House 40 Chapter Three Relief and Regulation of the Poor 92 Chapter Four The Factory Question Agitated 130 Chapter Five Debility and the Machine 175 Chapter Six The Changing Pattern of Provision 201 Chapter Seven The Factory Eclipsed: Domestic Habits and Personal Failings 226 Chapter Eight The Broken Bond 282 Conclusion 313 Bibliography 328 Appendix I Contributions of Selected Manchester Medical Men to the 1815-1819 Debate on the Factory Question 357 -v LIST OF TABLES Table I Position of Selected Manchester Medical Men on the Factory Question 170 -vi- ACKNOWLEDGEMENT I would like to thank my supervisor, Professor Harvey Mitchell, for his unfailing kindness and support and for his patience with a project that has gone on longer than either of us anticipated. I would also like to thank Professor Peter Ward for his willingness in assuming the position of co-supervisor and for his generous encouragement and advice. I would like to express my gratitude, as well, to Professor John Pickstone, Doctor Stella Butler, and other former members of the University of Manchester Institute of Science and Technology for welcoming me into their midst, guiding me to local libraries and record offices, and sharing their understanding of medical history. Their efforts helped me acquire a feeling for Manchester and its past that made subsequent research all the more meaningful. —1— INTRODUCTION As textile mills assumed greater visibility in the landscape of early industrial Britain, so, too, the health of those who laboured inside the mills came to occupy a growing space in public awareness. In the late eighteenth and early nineteenth centuries, the condition of mill workers was a matter which provoked increasingly widespread concern and controversy. Medical men, as well as manufacturers and operatives themselves, became preoccupied with the possible links between machine production and human affliction and reacted in various ways to evidences of suffering and distress. Their shifting understanding of and responses to the ill-health of the manufacturing population form the subject of my dissertation. The issue of worker ill-health has attracted historical attention since the 1930s, when it was taken up by the early American historians of medicine, Henry Sigerist and George Rosen. In 1936 Sigerist wrote an article on the “Historical Background of Industrial and Occupational Diseases” and corresponded with Rosen, urging him to undertake a full-length study of 1 occupational health. The following year Rosen published a short historiographical essay and in 1943 completed a monograph on ‘Henry E. Sigerist, “Historical Background of Industrial and Occupational Diseases,” Bulletin of the New York Academy of Medicine, 2nd series, 12 (1936), pp. 597-609; Elizabeth Fee, “Henry E. Sigerist: His Interpretations of the History of Disease and the Future of Medicine,” in Charles E. Rosenberg and Janet Golden (eds), Framing Disease: Studies in Cultural History (New Brunswick, N.J.: Rutgers University Press, 1992), p. 303. -2- History of Miners’ Diseases, which Sigerist contributed 2 After to an introduction. their pioneering efforts, several decades passed with little appearing on the topic.3 The early 1980s, however, saw a resurgence of interest in occupational health on both sides of the Atlantic which has continued to the present, and which has expressed itself in conference gatherings, research projects, and a spate of books and articles.4 In their writings, Sigerist and Rosen argued for the need to take a broad social approach to the historical investigation of work-related sickness. According to Rosen, the “frame of reference” for such investigation should be “the social structure in its economic, technologic, political, religious and cultural aspects.”5 Later scholars have 2George Rosen, “On the Historical Investigation of Occupational Diseases. An Aperçu,” Bulletin of the History of Medicine 5 (1937), pp. 941-946; The History of Miners’ Diseases: A Medical and Social Interpretation (New York: Schuman’s, 1943). 3Exceptions include Ludwig Teleky, History of Factory and Mine Hygiene (New York: Columbia Press, 1948) and Donald Hunter, The Diseases of Occupations (London: The English Universities Press Ltd., 1955). A textbook on occupational medicine, Hunter’s work contained a lengthy historical introduction and was reprinted several times in the 1950s and 1960s. 41n 1983 the British Society for the Social History of Medicine held a conference on “The History of Occupational Medicine,” some of whose papers appear in Paul Weindling (ed), The Social History of Occupational Health (London: Croom Helm, 1985). In the same year the Hastings Centre in New York conducted a study of occupational health entitled “Moral Responsibilities and Moral Decisions in Science and Engineering.” The results of the study are contained in Ronald Bayer (ed), The Health and Safety of Workers: Case Studies in the Politics of Professional Responsibility (New York: Oxford University Press, 1988). In 1994, at the annual meeting of the American Association for the History of Medicine, the Sigerist Circle met to discuss “Occupational Health and the Politics of Knowledge.” In “Accidents and Ill-Health: The Hidden Wages of the Workplace,” Social History of Medicine 3 (1990), p. 292, P.W.J. Bartrip links the swell of interest in worker health in the U.S.A. to the passing of the first federal Occupational Health and Safety Act in 1970. 5Rosen, “Historical Investigation,” 945. p. -3-. heeded their concern and have continued to be attentive to the role of economic, technological, political and cultural factors in shaping the experience of occupational illness and the introduction of measures aimed at alleviating or preventing it. Some historians, such as Gill Burke and Alan Derickson, have shown how the technical innovations and economic expansion associated with industrialization increased the risks of disease, disability and