Sci & Culture in the Nineteenth Century

Medicine and Modernity in Nineteenth-Century Britain

Amelia Bonea, Melissa Dickson, Sally Shuttleworth, Jennifer Wallis

• Publisher: University of Pittsburgh Press
• Year: 2019
• ISBN:
  9780822986607
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Much like the Information Age of the twenty-first century, the Industrial Age was a period of great social changes brought about by rapid industrialization and urbanization, speed of travel, and global communications. The literature, medicine, science, and popular journalism of the nineteenth century attempted to diagnose problems of the mind and body that such drastic transformations were thought to generate: a range of conditions or "diseases of modernity" resulting from specific changes in the social and physical environment. The alarmist rhetoric of newspapers and popular periodicals, advertising various "neurotic remedies, " in turn inspired a new class of physicians and quack medical practices devoted to the treatment and perpetuation of such conditions. Anxious Times examines perceptions of the pressures of modern life and their impact on bodily and mental health in nineteenth-century Britain. The authors explore anxieties stemming from the potentially harmful impact of new technologies, changing work and leisure practices, and evolving cultural pressures and expectations within rapidly changing external environments. Their work reveals how an earlier age confronted the challenges of seemingly unprecedented change, and diagnosed transformations in both the culture of the era and the life of the mind.

Chapter 1

“The Influence of Employments on Health”

Work and Medical Discourses about Occupational Health

Experiences of modernity—of the “difference posed by the present,” as Partha Chatterjee put it—are often infused with concerns about physical and mental well-being, about the body and the mind’s inability to adapt to the demands of the present as opposed to the past.¹ In the nineteenth century, the health of “modern” men and women became a subject of discussion among a wide range of social actors, from politicians and administrators to medical men, workers, writers, and journalists. If, as many Victorians were keen to point out, theirs was an era of progress and modernization, of sustained mechanization and industrialization, it was also a period of questioning and introspection. As contemporary observers struggled to come to grips with the disruptive consequences of ongoing socioeconomic and technological change, many questioned the ways in which science and the “progress of civilization” affected the fabric of society and influenced the physical and moral well-being of its members.

This chapter examines work as one of the main sites where anxieties about “modern life” were played out in the nineteenth century.² Indeed, as discussed in the introduction, “Work, of all kinds, was central to concerns about the diseases of modern life”; one of the most important outcomes of such anxieties was the gradual crystallization of occupational health as a distinct field of medical inquiry and public health intervention in the course of the nineteenth century. During this period, the human and environmental costs of ongoing industrialization and urbanization became increasingly visible to the public, mediated as they were by an explosion of print matter that brought cheap newspapers and other periodical publications within the reach of a growing audience of literate men and women. Many of the concerns about deteriorating bodily and mental health expressed through the medium of the popular and specialist press were linked to inadequate working conditions and practices, which often culminated in serious accidents. As Jamie Bronstein has cogently observed, such widely publicized accidents “called into question man’s ability to control and to progress, contravening the spirit of Victorian positivism.”³

The newspaper and periodical press also offered a platform for the dissemination of medical ideas about occupational diseases and was instrumental in raising awareness about the relationship between health and a person’s working environment. Charles Turner Thackrah’s (1795–1833) book, The Effects of the Principal Arts, Trades and Professions, and of Civic States and Habits of Living on Health and Longevity (1831), an early example of a burgeoning literature on occupational health, was widely reviewed in popular journals, including The Literary Gazette, Chambers’s Edinburgh Journal, The Imperial Magazine, and The Penny Magazine of the Society for the Diffusion of Useful Knowledge.⁴ A pioneer in the field of occupational medicine in Britain, Thackrah pertinently summed up contemporary anxieties associated with work practices:

If we turn our view from man to his works, we see the wilderness converted into towns and cities, roads cut through mountains, bridges carried over rivers and even arms of the sea, ships which traverse the globe, lakes converted into corn fields, forests made into pasture, and barren rocks covered with timber; in a word, we see the face of the world changed by human will and human power. If we look immediately at home, we observe the wonders which science and art have effected. We see large buildings, manufactures of almost every kind, and substances so changed, reformed, and combined, that nature could scarcely know her own productions. We admire the inventions of science, alike in their minuteness and their size, their accuracy, and their extent of operation. . . . These, and works like these, are assuredly wonderful. But while we admire, let us examine. What are the effects of these surprising works—effects, I mean, physical and moral?⁵

Thackrah’s question was not new. Enlightenment intellectuals and medical practitioners had also decried the negative effects of “modern life” on health. Jan Golinski has documented how, in the eighteenth century, “aerial pathologies” such as melancholy came to be regarded “to some extent [as] diseases of modern life,” with many commentators establishing a connection between the proliferation of such illnesses and their age’s growing appetite for “modern luxuries” in the form of tea, coffee, “fashionable clothing,” and “indoor entertainment.”⁶ Thackrah himself was drawing on important predecessors in his attempt to diagnose the impact of the working environment on the health of various categories of workers, among them occupational groups as diverse as “operatives,” merchants, manufacturers, and “professional men.” The first clues of these intellectual debts can be gauged from the text itself, in particular the extended second edition of The Effects of the Principal Arts, Trades and Professions, published in 1832. In it, Thackrah references extensively the work of the Italian physician Bernardino Ramazzini (1633–1714), author of the first comprehensive treatise on occupational health, De morbis artificum diatriba, first published in Latin at Modena in 1700 and usually translated into English as Diseases of Workers. In fact, as this chapter discusses, in the nineteenth century Ramazzini already had the reputation of a “father” figure in the emerging field of occupational health, his book being one of the “classics” with which medical authors often engaged.⁷

Taking a cue from nineteenth-century medical authors, this chapter uses Ramazzini’s pioneering work—its subsequent reception, transformations, adaptations, or rejections—as a springboard for pondering, from a historical perspective, the changing relationship between work, modernity, and occupational illness in the nineteenth century. If, as suggested above, Thackrah’s question about the relationship between health and the environment in which one worked was not new, then what about the answers to that question? In order to contextualize nineteenth-century debates about work and occupational health, but also to understand what was novel about them, the chapter traces the reception of Ramazzini’s ideas in a range of eighteenth- and nineteenth-century historical material from Britain, Italy, France, and Germany, in the form of medical treatises, dissertations, essays, lectures, correspondence, and book reviews, many of which were published in the popular and scientific periodicals of the time. The aim is to examine the development of conceptual and nosological frameworks for understanding the etiology, pathogenesis, and symptomatology of occupational diseases during the nineteenth century, their connection with earlier medical thought and practice, and the ways in which relevant scientific knowledge was produced and disseminated during this period.

Processes of knowledge production about occupational health can be seen to be transnational and dialogical in nature, and translation plays an important role in the production and circulation of scientific knowledge. Translation is understood here not only as the process of rendering a scientific text from a source language into a target language, but also as an intertextual practice that allows knowledge to move across various genres and media of communication. This analysis opens up a broader and more inclusive understanding of the “workplace” in its relation to health in the nineteenth century, one that recognizes that discussions about occupational hazards were linked to a wide range of activities. Although mines, collieries, factories, and railways provided some of the most compelling examples of work-related bodily injury and emerged, in both popular and scientific literature, as conspicuous sites of occupational injury, they were by no means the only risk-prone working environments.⁸ Many nineteenth-century medical commentators recognized this fact, remarking that the great diversity of occupational pursuits that characterized their age had translated into a bewildering number of “distempers,” “maladies,” “disorders,” and “accidents.” Put differently, bodily and mental illness in the nineteenth century was associated with a wide range of occupations across the social spectrum, ranging from mining and chimney sweeping to nursing, operating sewing machines, and even singing and writing, although not all of these conditions engaged the attention of legislators or led them to address specific conditions to the same degree. This comprehensive, encyclopedic approach to occupational health was an important legacy of Ramazzini’s early work in this field, demonstrating not only the extent to which nineteenth-century writers were indebted to the previous corpus of medical knowledge and practice but also the ways in which they departed from it.

Eighteenth-Century Models and Approaches

The notion that work and the environment in which it was conducted had a direct bearing upon the physical and mental well-being of the worker had a long pedigree. In antiquity and the Renaissance, medical thinkers investigated how certain types of work, along with ecological factors such as climate and water, influenced health and promoted the onset of disease. Mining, a particularly dangerous occupation, also attracted the attention of famous medieval scholars such as Agricola (1494–1555) and Paracelsus (1493–1541); for example, the latter’s posthumous work, Von der Bergsucht und anderen Bergkrankheiten (“On the Miners’ Sickness and Other Miners’ Diseases”), was innovative in its discussion of respiratory diseases and its “attempt to relate [them] to the general body of medical knowledge and theory.”⁹ But it was during the Enlightenment, as a number of authors have also pointed out, that many modern notions about public health took shape and crystallized.¹⁰ Ramazzini’s work on various types of occupations and the diseases incident to them is an important example in this respect. Unlike its predecessors, which focused on a single occupational group, Ramazzini’s De morbis artificum diatriba was a more ambitious project that attempted to account for a broader range of occupational diseases and categories of workers. The first edition, published in 1700, described no fewer than forty-three types of occupations and was reprinted in 1713 with a “Supplement” that included an additional thirteen. Among those whose health and work conditions were scrutinized were glass-makers, glass-grinders, porters, sailors, and “tradesmen who sit too much.”¹¹

Two main nosological principles can be distilled from the structure of the book. First, diseases were classified according to the type of work to which they pertained, with each chapter dedicated to the discussion of a set of medical conditions associated with a particular occupational group. Second, they were also organized according to etiology, with two main risk factors being identified: exposure to noxious substances and mechanical hazards. Ramazzini’s nosology was informed by a combination of humoral theories of disease and the idea that external factors were also responsible for ill health and death, which had been popular in Italy since the seventeenth century.¹² Strongly influenced by Hippocrates, who posited a link between disease and environment, Ramazzini operated with an understanding of the workplace as an all-encompassing habitat. Occupational illness was thus a function of various factors that converged in the workplace environment, such as the repetitive nature of certain work practices, the use of dangerous materials and technologies, and the action upon the body of the atmosphere.

Ramazzini’s concern with nosology, unsurprising in the context of his time, was related to a broader interest in classification that also extended to plants, animals, languages, and human beings. Such interest became increasingly conspicuous in the eighteenth century.¹³ As Matthias Dörries has pointed out with regard to natural philosophy, for Enlightenment thinkers classification was “one means to achieve clarity and rational order,” an impulse that stemmed from a “concern for completeness” and the desire to map, as comprehensively as possible, future areas of investigation.¹⁴ At the same time, the drive toward classification was also a reaction to the perceived “information overload” in the sixteenth and seventeenth centuries—the nineteenth-century incarnations of this phenomenon have been discussed in the introduction—which resulted in the publication of numerous dictionaries and encyclopedias that aimed to organize this information coherently and systematically.¹⁵ The preoccupation with organization and classification continued in the works of the nineteenth-century medical writers discussed, many of whom had learned to think about the connection between health and occupation within an analytical and methodological framework not dissimilar to the one developed by Ramazzini.

Translation played an important role in this context. Although tracing the number of translations, reprints, and new editions of Ramazzini’s Diseases of Workers is beyond the scope of this chapter, there are indications that the book enjoyed a substantial degree of popularity in the eighteenth and nineteenth centuries.¹⁶ According to a list compiled at the beginning of the twentieth century by Franz Koelsch, by the 1850s the work had been published eight times in Latin, four times in Italian, three times in French, four times each in German and English, and once in Dutch.¹⁷ The eighteenth-century doctor Johann Christian Gottlieb Ackermann (1756–1801), who translated Ramazzini’s book into German, also wrote that by 1780 the Diseases of Workers had been reprinted nine times as a distinct work and seven times as part of volumes of Ramazzini’s collected medical work.¹⁸

The book’s popularity stemmed partly from Ramazzini’s own reputation as a physician in eighteenth-century Italy and his association with the renowned medical schools at Padua and Modena. A late eighteenth-century Dutch visitor to Padua, W. X. Jansen, described the university there as “formerly one of the most celebrated in Europe” and attributed its fame to the “superior learning” of professors such as Andreas Vesalius, Sanctorius, Bernardino Ramazzini, and Giovanni Battista Morgagni.¹⁹ At the same time, Ramazzini’s holistic approach to the study of occupational health also contributed to the broader appeal of the book, making it relevant to a larger group of medical and scientific men. A 1702 review in Actorum Eruditorum, a scientific periodical published in Leipzig in the late seventeenth and early eighteenth centuries, underscored the book’s utility for physicians as well as “amateur scientists” (Amateurs des Sciences).²⁰ Similarly, Ackermann believed that there was a “general agreement about the value of the work and there is probably no medical doctor who cannot find something useful in it,” while the chemist Antoine François de Fourcroy (1755–1809), Ramazzini’s French translator, revealed that the book’s potential public relevance had provided the incentive for its translation.²¹ The appeal of Ramazzini’s work in the eighteenth century was also connected to other imperatives, as Vincent pertinently reminds us: in England, with the expansion of a “market of treatments and remedies,” as demonstrated by the case of Dr. Robert James, one of Ramazzini’s English translators, and in Germany with the emergence of a “medical police” whose authority, away from the urban centers, relied on a network of physici and translators like Ackermann and Julius Heinrich Gottlieb Schlegel.²²

In Ramazzini’s work we witness the emergence of a model of investigating occupational diseases that, through subsequent translations into a number of European languages, would prove influential in the development of medical thinking about occupational health. Some of the most important characteristics of this “Ramazzinian mode of investigation,” as the British physician Benjamin Ward Richardson (1828–1896) was to refer to it in the nineteenth century, were: the emphasis on the public relevance of studying occupational health; a recognition of the workers’ role in the production of medical knowledge about occupational pathologies; a nosology of occupational diseases that recognized two main types of causative agents, namely exposure to noxious substances and mechanic causes; and finally, an understanding of occupational disease that cut across economic lines and gender and included almost every type of work, from menial laborers to surgeons and “learned men.”²³

In writing his treatise, Ramazzini relied heavily upon the intellectual heritage of famed predecessors and contemporaries such as Hippocrates, Galen, Avicenna, Agricola, and the German physicians Michael Ettmüller (1644–1683) and Georg Wolfgang Wedel (1645–1721), as well as the English doctor Thomas Willis (1621–1675), founding member of the Royal Society, whose observations on urine and diabetes he referenced extensively.²⁴ The influence of Hippocrates and Galen is particularly notable. The book is lad...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Acknowledgments
• Introduction
• 1. “The Influence of Employments on Health”: Work and Medical Discourses about Occupational Health
• 2. Technologies of Modernity: Telegraphs, Telephones, and Medical Practice in the Nineteenth and Early Twentieth Centuries
• 3. Unhealthy Economies: Illness and Infection in British Coastal Resorts
• 4. The Woman Secret Drinker in the Late Nineteenth-Century Press
• 5. Knocking Some Sense into Them: Overpressure Debates and the Education of Mind and Body
• 6. Bringing Them Up to Speed: Nineteenth-Century Nervous Systems and Cultural Fantasies of Adaptation
• Conclusion
• Notes
• Bibliography
• Index