Ferriar's Fever to Kay's Cholera: Disease and Social Structure in Cottonopolis

This paper was first presented to the Society for the Social History of Medicine at the Annual Conference, July 1980, Liverpool University. I am grateful to that audience for their comments, and to Roy Porter and Roger Cooter for suggesting subsequent revisions. Roy Porter's useful paper for the SSHM in 1984, makes some similar points about London: “Cleaning up the great wen: Public health in eighteenth century London”.

Cooter Roger , “Anticontagionism and history's medical record”, in Wright P. Treacher A. (eds), The problem of medical knowledge (Edinburgh, 1982). Several other essays in this volume are similarly concerned with the relationships between social history and changing medical theories. Also see Lawrence Chris , “The nervous system and society in the Scottish enlightenment”, in Barnes Barry Shapin Steven (eds), Natural order: Historical studies of scientific culture , and Cooter's essay in that volume; Pickstone John V. , “Bureaucracy, liberalism and the body in post-Revolutionary France: Bichat's physiology and the Paris School of Medicine”, History of science, xxix (1981), 115–42; Weindling Paul , “Theories of the cell state in Imperial Germany”, in Webster C. (ed.), Biology, medicine and society, 1840–1940 (Cambridge, 1981).

In general these studies are concerned with physiological doctrines and approaches characteristic of particular historical milieux. Without denying the collective learning or individual creativity characteristic of medicine, science or other cultural traditions, they seek to understand specific intellectual forms by reference to specific historical contexts. In my opinion this body of work, taken with older studies by Temkin and Rosen, Pagel and others, clearly demonstrates the ‘homologies’, the ‘parallels’, the ‘reflections’ of social forms in scientific theory, and the need to explain these phenomena. Possible explanations range from the conscious ‘advancement’ of medical ideology for purposes of social legitimation, to the semi-conscious or unconscious utilization of new ‘social logics’ in the creation of new explanatory structures within medicine. Such explanations need not be exclusive, nor should they be understood within crude oppositions of ‘science’ and ‘society’. The more successful of the case studies demonstrate the richness of lived connections between technical texts and broad historic contexts. In the present study, the organizers of medical reports and medical polemics are also the organizers of medical services and the would-be-reformers of civic life. The ranges of activity and of discourse are not easily divided up or separated one from the other.

Simon John , English sanitary institutions (London, 1890), ch. 8. Also see Rosen George , A history of public health (New York, 1958), and From medical police to social medicine (New York, 1974).

Keith-Lucas B. , “Some influences affecting the development of sanitary legislation in England”, Economic history review, 2nd ser., vi (1953), 290–6; Hennock E. P. , “Urban sanitary reform a generation before Chadwick?”, Economic history review, 2nd ser., x (1957), 113–20.

Webster Charles , “The crisis of hospitals during the industrial revolution”, in Forbes E. (ed.), Human implications of scientific advance. Proceedings of the XVth International Congress of the History of Science, Edinburgh, August 1977 (Edinburgh, 1978), 214–23; Pickstone John V. Butler S. V. F. , “The politics of medicine in Manchester 1788–1792: Hospital reform and public health services in the early industrial city”, Medical history, xxviii (1984), 227–49.

For a recent thorough national and regional study and bibliography see Godwin Albert , The friends of liberty: The English democratic movement in the age of the French Revolution (London, 1979). Also Dickinson H. T. , Liberty and property: Political ideology in eighteenth century Britain (London, 1977).

Hindle G. B. , Provision for the relief of the poor in Manchester, 1754–1826 (Manchester, 1975), ch. 8.

Ibid., ch. 7, and the Reports of the S.B.C.P.

Manchester Infirmary Annual Reports and Minutes. And see Pickstone Butler , op. cit. (ref. 5).

The main source for the early history of the House of Recovery is the printed Proceedings of the Board of Health of Manchester (Manchester, 1806).

Thomson Elizabeth H. , “The role of physicians in the Humane Societies of the eighteenth century”, Bulletin of the history of medicine, xxxvii (1963), 43–51.

For example, Bichat M. F. X. , Recherches physiologiques sur la vie et la mort (Paris, 1800). Contrast Kay J. P. , The physiology, pathology and treatment of asphyxia (London, 1834). See Pickstone , op. cit. (ref. 2).

Ferriar John , Medical histories and reflections , i, 235 (London, 1810). The “close rooms of an elegant house” did not produce fevers, probably because anxiety and depression were there absent.

The public health question in relation to prisons receives an excellent discussion in Michael Ignatieff, A just measure of pain: The penitentiary in the Industrial Revolution, 1750–1850 (London, 1978). Also see Marcovich Anne , “Concerning the continuity between the image of society and the image of the human body: An examination of the work of the English physician J. C. Lettsom (1746–1815)”, in Wright Treacher (eds), op. cit. (ref. 2), 69–86. Ms Marcovich, who kindly provided me with a copy of her thesis on Lettsom, has shown convincingly how notions such as circulation were central to both the medical and the social thought of key British dissenting, reforming physicians of the late medical enlightenment. Over-proximity and under-ventilation, by restricting the circulation of air, clogged the natural exchange and so produced pathological changes.

The views of the Northern physicians on ‘air’ and ‘contagion’ are now being examined by Margaret DeLacey, especially as they relate to the architecture of hospitals, prisons and workhouses. A preliminary paper was given to the (American) Social Science History Association (1982).

Behind my connections of medicine to political economy, and behind those of Marcovich, lies some of Michel Foucault's work. The divide he presents in Les Mots et les choses (1966) (The order of things (London, 1970)) between the exchange theorists and the classical economists, would surely be a useful tool in the detailed examination of shifts in ‘medical economy’. Classical economy, with Ricardo and Malthus, is about population and the limited possibilities of production: “Homo oeconomicus is not the human being who represents his own needs to himself, and the objects capable of satisfying them; he is the human being who spends, wears out, and wastes his life in evading the imminence of death” (The order of things, 257).

Pickstone Butler , op. cit. (ref. 5).

Ferriar , Medical histories and reflections, i, 247–8.

Kay James Phillips , The moral and physical condition of the working classes… in Manchester (London, 1832). There were two editions. I have used the second, reprinted in 1969 by E.J. Morten, Didsbury, Manchester.

Walker's Jane thesis on “John Ferriar of Manchester, M.D.: His life and work” (MSc., UMIST, 1973), is a convenient compendium; on Kay see Smith Frank , The life and work of Sir James Kay-Shuttleworth (London, 1862). Also Johnson Richard , “Educational policy and social control in early Victorian England”, Past and present, xlix (1970), 96–119.

I owe this and several other details of the 1832 Board to Mark Clifford and his BA thesis, “Medicine, politics and society: Manchester's 1832 cholera epidemic” (Department of History, University of California, Berkeley, 1979).

Weber Gay , “Human sciences and the role of women in industrial society” (unpublished paper given to the Conference of the Society for the Social History of Medicine, 1980); idem, “Degeneration and progress in early nineteenth century social theory” (unpublished paper given to the Conference of the SSHM, 1976).

Rev. Sir Wm Clerke, Thoughts upon the means of preserving the health of the poor by prevention and suppression of epidemic fevers, addressed to the inhabitants of Manchester and of the several populous trading towns surrounding and connected with it (London, 1790).

Ibid., 4–6.

Ibid., 15.

Hindle G. B. , Relief of the poor (ref. 7), 78–89.

Infirmary Manchester , Quarterly board minutes, 20 December 1792.

Dictionary of national biography; Archibald Prentice, Historical sketches and personal recollections of Manchester (1851; reprint, London, 1969), 118–19. For contemporary debates on the poor-law: Poynter J. R. , Society and pauperism: English ideas on poor relief 1795–1834 (London, 1969). Also see Brown Stewart J. , Thomas Chalmers and the godly commonwealth in Scotland (Oxford, 1982).

In describing Unitarians searching out savages I have followed the useful and stimulating work of Messinger G. S. , “Visions of Manchester: A study of the role of urban imagery in history, 1780–1878” (Ph.D. thesis, Harvard University, 1971). See also Perry H. E. , A century of liberal religion and philanthropy in Manchester (Manchester, 1933); and The monthly repository for the relevant years. Kay reproduced part of the report of the Mosley Street Christian Instruction Society in the appendix of his Moral and physical (ref. 16). This chapel, which Kay attended, had been a major source of support for the reformed Infirmary in the 1790s. On the public and private social world of the Manchester Unitarians see the interesting recent article by Seed John , “Unitarianism, political economy and the antinomies of liberal culture in Manchester, 1830–50”, Social history, vii (1982), 1–25.

Irvine H. C. , The old D.P.S. (Manchester, 1933).

I briefly discussed these missions and their relationships to the later Manchester & Salford Sanitary Association in a paper to the Society for the Social History of Medicine, 1978: “Medical subcultures in Victorian Lancashire, voluntarism and the establishing of medicine”.

On the Statistical Society see Ashton T. S. , Economic and social investigations in Manchester, 1833–1933 (London, 1934, reprinted Hassocks, Sussex, 1977); Cullen M. J. , The statistical movement in early Victorian Britain: The foundations of empirical social research (London, 1975).

Prentice , Historical sketches (ref. 25), 394. On the Heywood and the Gregs and other Unitarian families there is much information in the very useful thesis by Gatrell V. A. C. , “The commercial middle class of Manchester c. 1820–1857” (Ph.D. thesis, Cambridge University, 1972).

Article in Manchester Guardian, 18 June 1831, signed J.R., “Remarks on the axiom of political economists, that a general improvement in the duration of life indicates a corresponding improvement in public health”. Roberton John , General remarks on the health of English manufacturers (London, 1831). See the forthcoming MSc thesis by Joan Mottram on John Roberton (History of Science & Technology, UMIST).

Kay , Moral and physical (ref. 16), 17–18.

See ref. 2.

Gaulter Henry , The origins and progress of the malignant cholera in Manchester, considered chiefly in their bearing on the contagiousness and the secondary causes of the disease… (London, 1833). Gaulter, who characterized the influential members of the Manchester Board as “not… ultra, but determined contagionists”, was initially a member of the Board, but resigned from it. On the medical explanations of the first and second cholera epidemics see Pelling Margaret , Cholera, fever and English medicine (Oxford, 1978).

Cooper Thomas , “Sketch of the controversy on the subject of materialism”, in his Tracts, ethical, theological and political, i (London, 1787); Ferriar John , “Observations concerning the vital principle”, Memoirs of the Literary & Philosophical Society of Manchester, iv (1793), and “Some remarks on Dr Tatersall's ‘Brief view of the anatomical arguments for the doctrine of materialism’”, Medical histories and reflections, ii (1795), Appendix. These papers are briefly discussed in Jane Walker's thesis.

See, for example, Kiernan V. , “Evangelicalism and the French Revolution”, Past and present, i (1952), 44–56; Garfinkle Norton , “Science and religion in England, 1790–1800: The critical response to the work of Erasmus Darwin”, Journal of the history of ideas, xvi (1955), 376–88; Temkin O. , “Basic science, medicine and the Romantic era”, Bulletin of the history of medicine, xxxvii (1963), 97–129.

This exchange is discussed in Bynum W. F. , “Time's noblest offspring: The problem of man in the British natural historical sciences” (Ph.D. thesis, Cambridge University, 1974).

Greg Samuel , Two letters to Leonard Horner, Esq., on the capabilities of the factory system (London, 1840; reprinted New York, 1972, under the title Conditions of work and living: The reawakening of the English conscience, which also includes the Manchester Statistical Society's report on the Conditions of the working classes in an extensive manufacturing district (London, 1838)).

Durey M.J. , The return of the plague—British society and the cholera 1831–2 (Dublin, 1979).

Clifford , op. cit. (ref. 18).

Manchester Infirmary minutes; Kay J. P. , Defects in the constitution of dispensaries and suggestions for their improvement (London, 1834).

Manchester Courier, 1 September 1832.

Gaulter , Malignant cholera (ref. 34), 137–9.