Abstract
The intersection of new theories about contagion with a series of typhus epidemics in the late eighteenth century provided the rationale for a series of interventions that included new organizations, new procedures, new institutions and new buildings. This required the creation of new ways to communicate medical ideas to a larger public and produced conflicts fueled by differences in medical theories, religious allegiances, personal interest, political authority and social status. Using Manchester as an example, chapters 7 and 8 examine the interplay of these factors as a small but nationwide network of medical reformers tried to establish new ways for their communities to understand and prevent illness.
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Notes
- 1.
George Rosen associated the concept of “medical police” with “crumbling” European despotism and cameralism, an idea obliquely reflected in Erwin Ackerknecht’s assumption that the supporters of quarantines were “bureaucrats” opposed to liberalism. Historian Patrick E. Carroll reviewed theories about the creation of medical police and opposed the idea of English exceptionalism in “Medical Police and the History of Public Health,” Medical History (October, 2002), 46:461–94. Emily Cokayne documented efforts by local governments to curb a variety of nuisances in Hubbub: Filth, Noise and Stench in England, 1600–1770 (New Haven: 2008). John Pickstone called for the integration of contemporary theories of fever into this narrative in “Fever Epidemics and British ‘Public Health’, 1780–1850,” in Epidemics and Ideas: Essays on the Historical Perception of Pestilence, eds Terence Ranger and Paul Slack (Cambridge: 1992), 125–48, but he saw the story as a transition from traditional neoclassical (i.e. Galenic) medicine, which he associates with William Cullen, to Parisian “hospital medicine.” This understates both the divide between traditional medicine and eighteenth-century contagionism, and the social role of the contagionists as outsiders and critics of ancien régime England.
- 2.
There were occasional confrontations between a hospital doctor and a patient over a dubious treatment, but fear of being anatomized was a more common source of conflict, as was feuding among doctors.
- 3.
Charles Creighton, A History of Epidemics in Britain (London: 1965), vol. 2: From the Extinction of the Plague to the Present Time, 146–59; [A. Meiklejohn?], “The Putrid Fever at Robert Peel’s Radcliffe Mill,” Notes and Queries (1958) 203:26–35.
- 4.
“Putrid Fever,” 30. See also Margaret DeLacy, Prison Reform in Lancashire, 1700–1850: A Study in Local Administration (Stanford CA: 1986), 79–81.
- 5.
DeLacy, Prison Reform.
- 6.
The dispensary in Lancaster, which is also described as an infirmary, moved to a new location in 1785. David Campbell was its founder and first physician. Newcastle Dispensary also moved to larger quarters in 1783 and expanded. In the London area, new dispensaries had opened in Finsbury (1780), Whitechapel (the Eastern Dispensary) and Carey Street (1782). Lettsom was their most important founder. See William Hartston, “Medical Dispensaries in Eighteenth Century London,” Proceedings of the Royal Society of Medicine (August: 1963), 56, no. 8:753–8.
- 7.
David Campbell, Observations on the Typhus, or Low Contagious Fever (Lancaster: 1785). Campbell participated in the influenza surveys of 1775 and 1784, taking a contagionist position in both. Lancaster City Library, biographical files.
- 8.
Graham A. J. Ayliffe and Mary P. English, Hospital Infection from Miasmas to MRSA (Cambridge: 2003), 47.
- 9.
Accounts include J. V. Pickstone and S. V. F. Butler, “The Politics of Medicine in Manchester, 1788–1792,” Medical History (1984) 28: 227–49, which has a helpful overview and references to many primary and secondary sources. See also John V. Pickstone, Medicine and Industrial Society: A History of Hospital Development in Manchester and its Region, 1752–1946 (Manchester: 1985); Pickstone, “Ferriar’s Fever to Kay’s Cholera: Disease and Social Structure in Cottonopolis,” History of Science (1984) 22:401–19. Dr Pickstone provided a copy of this helpful article. See also Frank Renaud, A Short History of the Rise and Progress of the Manchester Royal Infirmary from the Year 1752 to 1877 (Manchester: 1898); Charles Webster and Jonathan Barry, “The Manchester Medical Revolution,” in Truth, Liberty, Religion: Essays Celebrating Two Hundred Years of Manchester College, ed. Barbara Smith (Oxford: 1986), 165–84. The other essays in this book are also useful.
- 10.
See “Putrid Fever.” Robert Peel was the father of the future prime minister. The article’s author could not determine exactly what the mill manufactured, though Peel referred to it as “the Cotton works.”
- 11.
A misplaced comma in “Putrid Fever” implies that they were the same people. The lord lieutenant from 1776–1834 was Edward Smith Stanley, 12th Earl of Derby. Thomas Egerton became Baron Grey de Wilton in 1784 and 1st Earl of Wilton in 1801.
- 12.
The best contemporary account is Sir William Clerke’s Thoughts upon the Means of Preserving the Health of the Poor by Prevention and Suppression of Epidemic Fevers.… (London: 1790). It includes not only the full text of the Percival report but extracts from David Campbell, Haygarth and Howard’s Lazarettos. I thank Dr Richard Wall for this reference. Mead’s book on plague and Pringle’s article on jail fever were created in response to requests from concerned authorities, but there is no evidence that there was any broader public involvement in initiating the request.
- 13.
Quarter sessions order, Manchester, Michaelmas 1784, in Clerke, 7.
- 14.
This is rpt in full in Clerke, Thoughts, 4–6.
- 15.
Clerke, Thoughts, 4–6.
- 16.
“Putrid Fever,” 27–8.
- 17.
David Turley, The Culture of English Antislavery, 1780–1860 (Abingdon, UK: 1991), 112–15.
- 18.
Padraig O’Brien, Warrington Academy, 1757–86; Its Predecessors and Successors (Wigan: 1989).
- 19.
The New College at Hackney, which succeeded Samuel Morton Savage’s Hoxton Academy, only survived until 1796. It employed Richard Price, Joseph Priestley, Andrew Kippis and Gilbert Wakefield. David L. Wykes, “The Contribution of the Dissenting Academy to the Emergence of Rational Dissent,” in Enlightenment and Religion: Rational Dissent in Eighteenth-Century Britain, ed. Knud Haakonssen (Cambridge: 1996), 99–139.
- 20.
Ditchfield, “Manchester College and Anti-Slavery,” in Smith, Truth, Liberty, Religion, 185–224,” 197; Richard Wade, The Rise of Nonconformity in Manchester with a Brief Sketch of the History of Cross Street Chapel (Manchester: 1880). Barnes became minister of the Cross Street Chapel in Manchester in 1780, a year before the Manchester Literary and Philosophical Society was founded.
- 21.
Ditchfield, “Manchester College,” 196. Dr John Jebb (see Chapter 6) was a founder of the Society for Constitutional Information.
- 22.
Published under the pseudonym of “Jasper Wilson,” Currie’s A Letter Commercial and Political Addressed to the Right Honourable William Pitt sold an estimated 10,000 copies and provoked several replies. William Wallace Currie, Memoir of the Life, Writings and Correspondence of James Currie M.D., F.R.S. of Liverpool, 2 vols (London: 1831), 1:163. Currie tried to steer a middle road between Pitt and Thomas Paine.
- 23.
G. M. Ditchfield, “The Campaign in Lancashire and Cheshire for the Repeal of the Test and Corporation Acts, 1787–1790,” Transactions of the Lancashire and Cheshire Historic Society (1977) 126:109–39.
- 24.
Ditchfield, “Campaign,” 114 and 117; Carl B. Cone, The English Jacobins (New Brunswick NJ: 2010), 76.
- 25.
John Chapple, Elizabeth Gaskell: The Early Years (Manchester: 1997), 16.
- 26.
As Pickstone and Butler point out, Manchester textile manufacturers, who had united against tariffs in 1784, split in 1788 between the fustian makers, led by Thomas Walker, and the calico manufacturers, led by Robert Peel, who supported Pitt. The religious reformers had also begun to fracture in 1788 when radical Unitarians left the proto-Unitarian Cross Street Chapel to found Mosley Street Chapel. Five years later a group of Swedenborgians led by the Painite curate William Cowherd left the Anglican St. John’s Church to form what became the Bible Christian Church. For middle-class dissension, see John Seed, “Unitarianism, Political Economy and the Antinomies of Liberal Culture in Manchester, 1830–50,” Social History (January, 1982) 7:1–25.
- 27.
J. Phillip Dodd, “South Lancashire in Transition: A Study of the Crop Returns for 1795–1801,” Transactions of the Historical Society of Lancashire and Cheshire (1966) 117:89–107.
- 28.
Ditchfield, “Campaign,” 114–15.
- 29.
Ditchfield, “Campaign,” 127.
- 30.
Peter M. Jones, “Living the Enlightenment and the French Revolution: James Watt, Matthew Boulton, and Their Sons,” Historical Journal (1999) 42:157–182; Ditchfield, “Campaign,” 127–8.
- 31.
The contagiousness of revolutionary ideology was a metaphor used optimistically by radicals: the orator John Thelwall wrote in 1794 that his lectures “have shaken the pillars of corruption.… Every sentence darted from breast to breast with electric contagion.” E. P. Thompson, The Making of the English Working Class (New York: 1963), 141.
- 32.
Modeled on the London Association for Preserving Liberty and Property against Republicans and Levellers. See Edward Smith, The Story of the English Jacobins (London: ca. 1881), 101; Pickstone and Butler, 234.
- 33.
Pickstone and Butler, 234.
- 34.
Brockbank, Portrait of a Hospital 1752–1848: To Commemorate the Bi-Centenary of the Royal Infirmary, Manchester (London: 1952), 31.
- 35.
Brockbank, Portrait, 31.
- 36.
Reynaud, Short History, 27. The board had contracted for enlargements at the asylum a year earlier (1787).
- 37.
Pickstone and Butler, 235.
- 38.
Pickstone and Butler, 235. Brockbank tactfully commented: “The visiting of the home-patients was so much appreciated that the work was becoming a burden to the staff. It was therefore decided to appoint two physicians.”
- 39.
Pickstone, “Ferriar’s Fever,” 403. Pickstone wrote that “the expansion of the Infirmary in 1790 was the major concrete achievement of Manchester radicalism.”
- 40.
In the paper on materialism, read November 12, 1790, Memoirs of the Manchester Literary and Philosophical Society (1793–6) 4:20–44, Ferriar argued that there are medical reports of every part of the brain being destroyed without the loss of the patient’s power of thought. In “On the Vital Principle” he argued that there was no conclusive proof that this existed.
- 41.
Pickstone and Butler, 237.
- 42.
Pickstone and Butler, 238–9.
- 43.
Brockbank, Portrait, 32. Brockbank said the decision to create new fever wards was rescinded at the next meeting, but in fact the wards were in the new dispensary building when it opened. See Chapter 8 below.
- 44.
Pickstone and Butler, 239.
- 45.
Reynaud, Short History, 34.
- 46.
Reynaud, Short History, 35.
- 47.
Pickstone and Butler, 291.
- 48.
This dispute led Percival to write a guide to professional conduct at the request of the trustees. It was published as Medical Ethics.
- 49.
Knight, Walker, 50. See also The Whole Proceedings on the Trial of an Action Brought by Thomas Walker, Merchant, against William Roberts, Barrister at Law, for a Libel (Manchester: 1791). Many historians of the turbulent 1790s mention Walker’s subsequent problems but few note that the conflict originated in this dispute over the control and mission of the infirmary.
- 50.
Knight, Walker, 49–55.
- 51.
Knight, Walker, 56.
- 52.
John Ferriar, ed., “Epidemic Fever of 1789, and 1790,” in Medical Histories and Reflections, 4 vols (London) 1:117–43, on 171. Volume 1 appeared in 1792, volume 2 in 1795, volume 3 in 1798 and volume 4 appeared in 1810 together with reprints of volumes 1–3. The Google Books and Internet Archive version combines volume 1 with volume 2 in a single link under the date 1792.
- 53.
Ferriar, “Epidemic Fever,” 178.
- 54.
Ferriar, “Epidemic Fever,” 178–9
- 55.
Ferriar, “Of the Prevention of Fevers in Great Towns,” Medical Histories and Reflections, vol. 2 (1795), 202.
- 56.
Ferriar, “Prevention of Fevers,” 209.
- 57.
Separation of the sick was not unprecedented in the town. During a plague epidemic in 1605–1606, Manchester had erected a pest house and supplied it with straw, coals, clothes and other goods. In an epidemic in 1625 the town erected wooden cabins thatched with straw to isolate infected denizens who were fed at the town’s expense. When plague struck an inn in 1631, killing nearly everyone inside, the town constables burned all the goods in the house and apparently limited the disease to that dwelling. Plague returned in 1645, during the English Civil War, killing many inhabitants and leading to quarantine of the entire town. Arthur Redford, The History of Local Government in Manchester (London: 1939), vol. I: Manor and Township, 122–7.
- 58.
Lucas,“Remarks on Febrile Contagion,” 260–61.
- 59.
Clerke, Thoughts, 4–7. I thank Dr Richard Wall for this reference.
- 60.
Clerke, Thoughts, 9–10.
- 61.
Eighteenth-century England had no national police force. Clerke was evidently thinking about a national network of laws and policies and/or an information chain that led from localities up to the Home Office. See George Rosen, “Cameralism and the Concept of Medical Police,” Bulletin of the History of Medicine (1953) 27:21–42; Rosen, From Medical Police to Social Medicine: Essays on the History of Health Care (New York: 1974); Carroll, “Medical Police,” esp. 465–9.
- 62.
Clerke, Thoughts, 16. Clerke’s more pithy version of this advice was reprinted in Medical [and Philosophical] Commentaries (1792) 16:353–8 with a follow-up letter on 359–62 from Percival to Dr Andrew Duncan, the journal’s editor. Underlining the close-knit nature of this group, Duncan dedicated the volume to his London friend Dr Samuel Foart Simmons. Percival’s own advice was reprinted in Joseph Johnson’s radical journal The Analytical Review (January–April 1790) 6:460–2.
- 63.
Clerke, Thoughts, 21. Clerke appended samples of the tabular reports and accounts that were prepared for donors.
- 64.
Clerke, Thoughts, 19.
- 65.
Clerke, Thoughts, 18.
- 66.
Clerke, Thoughts, 17.
- 67.
Clerke, Thoughts, 17.
- 68.
John Emsley, Elements of Murder: A History of Poison (Oxford: 2005), 203–4; Geoffrey Marks and William K. Beatty, The Precious Metals of Medicine (New York: 1975), 46–52.
- 69.
Arsenic in small doses was used as a febrifuge and tonic in the form of Fowler’s solution, developed by Thomas Fowler in 1786. Arsenic is still used in medicine. K. H. Antman, “Introduction: The History of Arsenic Trioxide in Cancer Therapy,” The Oncologist (2001) 6 suppl. 2: 1–2, online from PubMed at PMID 11331433.
- 70.
Chapple, Elizabeth Gaskell, 34–5; Ditchfield, “Campaign,” 126. See also R. B. Rose, “The Priestley Riots of 1791,” Past and Present (1960) 18:68–88.
- 71.
The boroughreeve was the highest elected manorial officer, roughly equivalent to a mayor in status. See Redford, 1:50–51
- 72.
Thomas Butterworth Bayley served on the grand jury that returned the indictment. The Whole Proceedings on the Trial of an Indictment against Thomas Walker…for a Conspiracy to Overthrow the Constitution and Government…. (Manchester: 1794), xv. Among the co-defendants was Joseph Collier, a Manchester surgeon and Quaker, 65.
- 73.
Born an Anglican, Walker became a Unitarian. William Henry Chaloner, Industry and Innovation, Selected Essays, eds D. A. Farnie and William Otto Henderson (London: 1990), 170. See also Archibald Prentice, Historical Sketches and Personal Recollections of Manchester Intended to Illustrate the Progress of Public Opinion from 1792 to 1832 (London: 1851), online from the Internet Archive; Frida Knight, The Strange Case of Thomas Walker (London: 1957); Pickstone and Butler, “Politics,” 234.
- 74.
Alfred A. Mumford, The Manchester Grammar School 1515–1915 (London: 1919), online from the Internet Archive. Lord Grey de Wilton had commissioned the report on the fever at the Peel’s Radcliffe mill (see this chapter above).
- 75.
See Dodd, “South Lancashire,” 105.
- 76.
J. H. Young, St. Mary’s Hospitals Manchester 1790–1963 (Edinburgh: 1964).
- 77.
A biography of Simmons and an account of this dispute is in Edward Mansfield Brockbank, Sketches of the Lives and Work of the Honorary Medical Staff of the Manchester Infirmary (Manchester: 1904), 169–81.
- 78.
William Simmons, Reflections on the Propriety of Performing the Caesarian Operation (Manchester: 1798); John Hull, A Defence of the Caesarian Operation, with Observations on Embryulcia…Addressed to Mr. W. Simmons (Manchester: 1798); William Simmons, A Detection of the Fallacy of Dr. Hall’s Defence (Manchester: c. 1798); John Hull, Observations on Mr. Simmons’ Detection etc. (Manchester: c. 1799). All are online from ECCO.
- 79.
Young, St. Mary’s Hospitals, 7–18; Pam Lieske, “Deformity of the Maternal Pelvis in Late Eighteenth-Century Britain,” in The Secrets of Generation: Reproduction in the Long Eighteenth Century, ed. Raymond Stephanson and Darren N. Wagner (Toronto: 2015), 319–43. The referring surgeon was “Mr. Ogden,” presumably James Ogden of Ashton (see Chapter 8). See also John Webster Bride, A Short History of the St. Mary’s Hospitals Manchester and the Honorary Medical Staff from…1790 to 1922 (Manchester: 1922). This dispute entangled the staff at the lying-in hospital when they felt compelled to carry out a cesarean operation in 1799. See Charles White, Richard Hall, George Tomlinson and John Thorp A Further Statement of the Case of Elizabeth Thompson.… (Manchester: 1799). The mother died but her child seems to have survived. Walter Radcliffe, Milestones in Midwifery and the Secret Instrument (San Francisco: 1989), 54, wrote that the dispute “divided the profession in Manchester into two camps, those following Hull at the Manchester Lying-in Charity and those supporting Simmons at the Infirmary.” However, Manchester had already split earlier between these two camps. See also Helen Churchill, Cesarean Birth: Experience, Practice and History (Hale, UK: 1997), 11; Henry Jellett, A Manual of Midwifery for Students and Practitioners (New York: 1910), 1081.
- 80.
Young, St. Mary’s Hospitals, 17.
- 81.
Pickstone and Butler, “Politics,” note that both Anglican Evangelicals and Methodists supported the expansion.
- 82.
John Coakley Lettsom, Of the Improvement of Medicine in London on the Basis of Public Good, 2nd edn (London: 1775), 51.
- 83.
Clerke, Thoughts, 23–4.
- 84.
John Pickstone, “Ferriar’s Fever to Kay’s Cholera: Disease and Social Structure in Cottonopolis,” History of Science (1984) 22:408 also quotes this passage from Clerke and draws the same conclusion.
- 85.
John Ferriar, appendix 1, Medical Histories and Reflections (London: 1798) 3:211–19.
- 86.
Ferriar, “Advice,” 212.
- 87.
Ferriar, “Advice,” 216.
- 88.
This was printed in Proceedings of the Board of Health in Manchester (London: 1805), 231–5. The board resolved that Bardsley’s letter should be published in the local newspapers and that 2,000 separate copies be printed for distribution. However, they also criticized the poor siting and construction of housing for the poor and the inattention of landlords, evidence that they were aware of the economic problems of Manchester’s poor.
- 89.
John Clark, “Appendix. No. 3. Instructions and Rules to Be Observed by the Patients of the Dispensary; First Printed in 1791,” in A Collection of Papers Intended to Promote an Institution for the Cure and Prevention of Infectious Fevers in Newcastle and Other Populous Towns…, vol. 1 (Newcastle: 1802). The “papers” in the anthology are separately paginated. This appendix is on 32–4 of the second item in the book: “Proceedings for Promoting an Institution for the Cure and Prevention of Contagious Fevers in Newcastle and Gateshead.”
- 90.
Dr. [Francis] Barker, “Extract from an Account of the House of Recovery for Fever Patients, Lately Established at Waterford,” and “Observations and Account of Its Progress,” in Reports of the Society for Promoting the Comforts of the Poor, ed. Francis Bernard (Dublin: 1800–02) vol. 1, no. 2, article 13: 89–93 and 94–107, online from ECCO. This was a separate publication from the English Bettering Society Reports.
- 91.
Barker, “House of Recovery…Waterford,” 106–7. See Chapter 8 for Ferriar’s claim that many Mancunians also lived in cellars with dirt floors.
- 92.
A. Wilson, Bath Waters, a Conjectural Idea of their Nature and Qualities, in Three Letters.… (Bath: 1788). Wilson (1718–1792), a Scot, had an Edinburgh MD (1749) and practiced in Newcastle and London. John P. Wright, “Wilson, Andrew (1718–1792),” ODNB (Oxford: 2004), http://www.oxforddnb.com/view/article/29635.
- 93.
Wilson, Bath Waters, 66.
- 94.
Wilson, Bath Waters, 52–3.
- 95.
Wilson, Bath Waters, 53. The miasmatist Florence Nightingale also felt contagionism promoted unethical behavior: “Does not the popular idea of ‘infection’ involve that people should take greater care of themselves than of the patient? that, for instance, it is safer not to be too much with the patient, not to attend too much to his wants?…True nursing ignores infection,” Notes on Nursing (London: 1860), 45–6.
- 96.
George Rosen, “John Ferriar’s ‘Advice to the Poor’,” Bulletin of the History of Medicine (1942) 11:222–7, on 222. In the event, Ferriar’s “Advice” was not distributed as he had intended, so his first sizeable audience were readers of his Medical Histories and Reflections (1798), 3:211–19, followed by readers of a reprint in 1800 in the widely distributed Bettering Society Reports. The readership of both these publications probably consisted mostly of middle-class professionals and philanthropists; the readership of Ferriar’s Medical Histories was probably weighted towards doctors. The Bettering Society reprint of “Advice” appeared in appendix 4 (1800) 2:271–76, a few pages after a reprint of Haygarth’s “Rules of Prevention”. According to its title page, the Bettering Society Reports were sold in eight London locations and in York, Bath, Newcastle, Durham, Hull, Salisbury, Exeter, Manchester and Gloucester.
- 97.
Rosen, “Ferriar’s ‘Advice’,” 222. See also John Pickstone, “Ferriar’s Fever to Kay’s Cholera: Disease and Social Structure in Cottonopolis,” History of Science (1984), 22:401–10, on 401.
- 98.
During the 1790s, loyalists were waging their own campaign, which not only included a huge outpouring of speeches, tracts and treatises aimed at a broad audience but also required tavern keepers and householders to sign loyalty oaths and spy on their customers, lodgers, workmen, servants and apprentices: E. P. Thompson, Making of the English Working Class, 115. Did these measures to destroy contagious ideas serve as a model for a “medical police” and the reporting of diseased neighbors? Did they inure the poor to inquisitions or stiffen resistance?
- 99.
John V. Pickstone, Medicine and Industrial Society (Manchester: 1985), 26.
- 100.
John Seed, “Gentlemen Dissenters: The Social and Political Meanings of Rational Dissent in the 1770s and 1780s,” Historical Journal (1985) 28:299–325, on 312. See also Seed, “ ‘A Set of Men Powerful Enough in Many Things’: Rational Dissent and Political Opposition in England, 1770–1790,” in Haakonssen, Enlightenment and Religion: 140–68; Seed, “Liberal Culture in Manchester, 1830–50,” Social History (1982) 7:1–25; Michael Durey, “William Winterbotham’s Trumpet of Sedition: Religious Dissent and Political Radicalism in the 1790s,” Journal of Religious History (1995) 19:141–57.
- 101.
Seed, “Rational Dissent,” in Haakonssen, Enlightenment and Religion, 167. Seed notes that Malthus attended Warrington Academy and implies that Malthusianism expressed the unease that bourgeois dissenters felt towards the poor. The primary imperative of medicine, however—to preserve lives—conflicted with the Malthusian credo of allowing “natural checks,” such as famine and disease, to circumscribe population growth.
- 102.
One example of this ambivalent stance was James Currie’s controversial biography of Robert Burns, which sympathized with his populism while deprecating his alcoholism.
- 103.
Dorothy Porter and Roy Porter, Patients’ Progress: Doctors and Doctoring in Eighteenth-Century England (Stanford: 1989), 170–1.
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DeLacy, M. (2017). Contagionism, Politics and the Public in Manchester, 1780–1795. In: Contagionism Catches On . Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-50959-4_7
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