The doctor in the Industrial Revolution.

Abstract

W. R. Lee, in his paper on Robert Baker published in a previous issue of this journal, has described Leeds, the home of both Baker and Charles Turner Thackrah, as 'the cradle of industrial medicine'.1 Leeds was doubtless unique in nurturing two such eminent practitioners of this branch of medicine, but many of the other expanding towns of the late 18th and early 19th centuries could claim to be the dwelling place of doctors keenly interested, if not in industrial medicine, at least in social medicine, in the application of their professional skills and know ledge to the problems of an industrializing and urbanizing society. Thus Manchester could boast Thomas Percival, John Ferriar, James Phillips Kay and Peter Gaskell; Liverpool, James Currie and William Duncan; Edinburgh, William Alison; and Sheffield, George Calvert Holland.2 In London the names were legion but included Southwood Smith, Neil Arnott, William Farr, Thomas Wakley, Edward Smith and John Simon prominent amongst them.3 Amongst smaller towns, Chester had its John Haygarth and Bristol its William Budd, and doubtless similar if less well known examples could be found in most urban communities of any size in this period.4 It is the object of this paper to assess the reasons for the growing interest and involvement of medical practitioners in the problems of social reform created by the first Industrial Revolution. One of the most important, vital and disturbing features of this process was the growth of the industrial town. Manchester, Leeds, Birmingham and their fellows symbolized in many ways the increasing power and wealth of the industrial and commercial middle class, presenting as they did a challenge to the long established social and political supremacy of the landed classes, the aristocracy, the squirearchy and the clergy of the Church of England. The architecture of the new towns, their factories and warehouses, chapels and town halls, and later their railway stations gave expression in concrete form to this increasing wealth, power and self-confidence. Weekly newspapers like the Man chester Guardian, the Leeds Mercury or the Bradford Observer voiced the opinions and demands of the urban middle classes. Literary and Philosophical Societies, Statistical Societies and Chambers of Commerce were formed to promote discussion of problems and to form opinion on them. In these aspects of urban development, the medical profession played a prominent role. In Leeds, it was a paper on 'Town Halls', read to the Leeds Philosophical and Literary Society by the secretary of the Leeds Improvement Society, Dr. J. D. Heaton, which launched the campaign to build a new town hall in Leeds, a development which Asa Briggs has des cribed as a 'case study in Victorian civic pride'.5 Robert Baker was a member of Leeds Town Council in the 1830s, and G. C. Holland an alderman of Sheffield in his later years.6 'Lit. and Phil.' and Statistical Societies were frequently dominated by professional men, with doctors well to the fore. Holland, a member of Sheffield Literary and Philosophic Society, remarked that of its 86 proprietors, subscribing two guineas per annum each, only 19 were commercial men, 'the remainder being generally professional gentle men or persons in easy circumstances'.7 C. T. Thackrah became the first secretary of the Leeds Philosophical and Literary Society after its formation in 1819.8 In Manchester, Thomas Percival and John Ferriar played an important part in the debates of the Literary and Philosophical Society in the 1790s, whilst some 40 years later James Kay was one of the founder members of the Manchester Statistical Society.9 In Liverpool, James Currie helped to revive the Literary Society and became its president.10 Yet, despite their prominent role in the activities of the new industrial towns, many doctors did not subscribe unreservedly to the creed of economic, religious and political freedom which some of their 22