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Institutionalizing Contagionism: The Manchester House of Recovery

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This chapter focuses on the creation of medical institutions in the eighteenth century and the debates that occurred about their function and mission. The establishment of the Manchester House of Recovery, the first purpose-built fever hospital, escalated the debate about contagion and pushed a professional issue into the public arena. Suddenly, entire communities discovered that they would be forced to gamble their health, their families, their property and perhaps their lives on administrative decisions about siting and designing fever hospitals and fever wards. The ensuing controversy forced the reformers to close ranks and sharpen their claims about the behavior of contagious diseases. Their victory literally institutionalized contagionism, at the moment when a new generation of reformers was beginning to redefine the issues at stake.

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  1. 1.

    Susan C. Lawrence, Charitable Knowledge: Hospital Pupils and Practitioners in Eighteenth-Century London (Cambridge: 1996), esp. table 2.1 on 39. See also Donna Andrew, Philanthropy and Police: London Charity in the Eighteenth Century (Princeton, NJ: 1989); Andrew, “Two Medical Charities in Eighteenth-Century London: The Lock Hospital and the Lying-In Charity for Married Women,” in Medicine and Charity Before the Welfare State, ed. Jonathan Barry and Colin Jones (London: 1991), 82–97; John Woodward, To Do the Sick No Harm: A Study of the British Voluntary Hospital System to 1875 (London: 1978); Kevin P. Siena, Venereal Disease, Hospitals and the Urban Poor: London’s “Foul Wards”, 1600–1800 (Rochester, NY: 2004). The website Lost Hospitals of London at has a list. The London Lives 1690 to 1800 website at includes the complete records of St. Thomas’s Hospital.

  2. 2.

    Lawrence, “Charitable Knowledge,” 39; I. S. L. Loudon, “The Origins and Growth of the Dispensary Movement in England,” Bulletin of the History of Medicine (1981) 55:322–342 has a useful table of both hospitals and dispensaries on 324–5. This does not include non-medical “hospitals” (i.e. almshouses) or workhouses.

  3. 3.

    The Evolution of Hospitals in Britain, ed. F. N. L. Poynter (London: 1964), esp. W. H. McMenemy, “The Hospital Movement of the Eighteenth Century and Its Development,” 43–71 and E. Gaskell “Bibliography of Hospital History,” 255–79, in the same volume which lists many older works, including histories of individual hospitals. See also Roy Porter, “The Gift Relation,” in The Hospital in History, ed. Lindsay Granshaw and Roy Porter (London: 1989), 149–78, on 150; and Adrian Wilson, “Conflict, Consensus and Charity: Politics and the Provincial Voluntary Hospitals in the Eighteenth Century,” English Historical Review (1996) 111, no. 442:599–619.

  4. 4.

    Porter, “Gift” describes them as (sometimes ineffective) efforts to paper over religious and social divisions. See also Mary E. Fissell, Patients, Power, and the Poor in Eighteenth-Century Bristol. Alured Clarke, who urged the creation of an infirmary in Winchester, parried objections that a workhouse would be more serviceable, that the poor might object to being removed from their homes, that there would not be enough patients to fill the hospital, and that it would attract too many poor people and beggars. Woodward, Do the Sick No Harm, 13.

  5. 5.

    Alured Clarke pointed out in 1736 that people needing surgery (presumably major surgery) had to obtain letters of recommendation to a London hospital and then spend three or four days in a wagon traveling from Winchester to London. Woodward, Do the Sick No Harm, 13. See also McMenemy, “Hospital Movement,” 48–51. Fissell points out that surgeons became much more dependent on hospital practice than physicians.

  6. 6.

    For the role of the London hospitals in medical education, see Lawrence, Charitable Knowledge. A surgeon at the Bristol Infirmary began teaching anatomy in 1740: Fissell, Patients, Power and the Poor, 129.

  7. 7.

    In one Liverpool election an anti-corporation candidate accused his opponents of using their positions in the charity school and infirmary to punish freemen voters for supporting him. F. E. Sanderson, “The Structure of Politics in Liverpool, 1780–1807,” Transactions of the Lancashire and Cheshire Historical Society (1977) 127:65–89, on 76.

  8. 8.

    Wilson, “Conflict,” argues that hospital creation fostered political peace in boroughs and was tied to electoral contests, especially when contested elections followed a period of relative harmony.

  9. 9.

    William Brockbank, Portrait of a Hospital 1752–1948…. (Toronto: 1952), 8. The donations later rose to £30 and £3.

  10. 10.

    Brockbank, Portrait, 8. These committees excluded women but were open to all men. Women did manage, or help to manage, institutions for women, such as lying-in charities.

  11. 11.

    Woodward, To Do the Sick No Harm, 146 argues that voluntary hospitals neither increased mortality nor greatly reduced it during the eighteenth century.

  12. 12.

    W. R. M. Drew, “Military Hospitals,” in Poynter, Evolution of Hospitals, 157–67. Two army hospitals built in London after the English Civil War soon closed.

  13. 13.

    For Barker, see Chapter 2.

  14. 14.

    Christopher Lloyd, “Naval Hospitals,” in Poynter, Evolution of Hospitals, 147–55. It contained 2,000 beds. John Howard called it the largest brick building in Europe, 151. Lord Sandwich, then a member of the Admiralty board, initiated the building of the naval hospitals in a report of 1744. Lloyd describes him as first lord of the Admiralty, a position he gained in 1748.

  15. 15.

    John Aikin noted that “the fatal necessity of receiving malignant fevers, into the military hospitals has been too often experienced, but no such necessity takes place in common practice,” Thoughts on Hospitals (London: 1771), 50–31.

  16. 16.

    Buer, Health, Wealth and Population in the Early Days of the Industrial Revolution (London: 1968), 198. See also John Clark, “Proceedings for Promoting an Institution…,” in A Collection of Papers Intended to Promote an Institution for the Cure and Prevention of Infectious Fevers in Newcastle and Other Populous Towns.… (Newcastle: 1802), vol. 1, item 2, 136. Hope (1725–1786, MD Glasgow), regius professor of botany and medicine, had been a student of Jussieu and edited Linnaeus’ works. He was one of Lettsom’s teachers. Hope’s ideas may have influenced Lind, instead of the other way around.

  17. 17.

    See Graham A. J. Ayliffe and Mary P. English, Hospital Infection: From Miasmas to MRSA (Cambridge: 2003), 47.

  18. 18.

    See also John Coakley Lettsom to John Clark, London, October 2, 1802, in Clark, “Proceedings,” in Collection, vol. 1, part 2, 54–5.

  19. 19.

    There were both Tory and Whig county infirmaries but both drew heavily on Anglican support. Wilson notes that four of the first five provincial hospitals were initiated by two people, Alured Clarke, cathedral dean at Exeter, and Lady Elizabeth Hastings, a pious Anglican philanthropist. In addition, the bishops of Gloucester and Worcester and the archbishop of Canterbury were active in early infirmaries. Ministers often used fundraising sermons to emphasize the value of piety and charity; later the infirmaries published them. See Wilson, “Conflict,” 600 and the sources listed in his n. 5. Perhaps the increasing numbers of Dissenters and Scots among infirmary staff also caused friction.

  20. 20.

    Trevor H. Levere, “Dr. Thomas Beddoes at Oxford: Radical Politics in 1788–1793 and the Fate of the Regius Chair in Chemistry,” Ambix (1981) 28:61–9, on 63.

  21. 21.

    Aikin, Hospitals, 9.

  22. 22.

    Aikin, Hospitals, 45–6.

  23. 23.

    Aikin, a young practitioner, may not have seen any patients with puerperal fever. His teacher, Charles White, who had studied with William Hunter and presumably knew what the illness looked like, wrote in 1783 that he had never lost a patient to puerperal fever after a natural labor and reported an overall maternal mortality for Manchester in 1771 of 5.1 in 1,000. Charles White, A Treatise on the Management of Pregnant and Lying-in Women (1773), rpt, ed. Lawrence D. London (Canton, MA: 1987), 64 and 138. Community epidemics of streptococcal disease increased in incidence and virulence from the mid-eighteenth to the mid-nineteenth century. This coincided with the incidence of hospital epidemics of puerperal fever, though British hospitals became increasingly effective in avoiding them. Margaret DeLacy, “Puerperal Fever in Eighteenth-Century Britain,” Bulletin of the History of Medicine (1989) 69:521–56.

  24. 24.

    Scarlet fever, also a streptococcal infection, was also seen as a “specific” contagion by the end of the century. See William Withering, An Account of the Scarlet Fever and Sore Throat (Birmingham: 1793).

  25. 25.

    Aikin, Hospitals, 52.

  26. 26.

    Aikin, Hospitals, 36–8.

  27. 27.

    Percival, “A Letter to the Author,” in Aikin, Hospitals, 87.

  28. 28.

    Armstrong obtained an MD from Aberdeen in the same year. His brother, the poet John Armstrong, had served with Pringle in Flanders. William J. Maloney, George and John Armstrong of Castleton: Two Eighteenth-Century Medical Pioneers (Edinburgh: 1954).

  29. 29.

    Maloney, George and John Armstrong, 69.

  30. 30.

    An Essay on the Diseases Most Fatal to Infants (London: 1767). Dedicated to Pringle, it was reprinted in 1771; in 1777 as An Account of the Diseases Most Incident to Children (1777) dedicated to the Queen; and in 1783. Unfortunately, Armstrong’s experiments on hemlock for whooping cough led him to criticize Lettsom’s work on that plant, triggering a hostile dispute in the Gentleman’s Magazine (1777) 47:416–18, 633–5. See Ashley Mathison, “Mineral Waters, Electricity, and Hemlock: Devising Theraputics for Children in Eighteenth-Century Institutions,” Medical History (2013) 15:28–44.

  31. 31.

    See the table in Irvine Loudon, “The Origins and Growth of the Dispensary Movement in England,” Bulletin of the History of Medicine (1981) 55:322–42, on 325. Loudon notes that by the end of the century, these dispensaries were serving at least 100,000 patients a year. The exact number of provincial dispensaries founded after 1770 is in doubt 323.

  32. 32.

    Loudon, “Dispensary Movement,” 325; F. J. W. Miller, “The Newcastle Dispensary, 1777–1976,” Archaeologia Aeliana 5th series (1990) 18:177–84. Joseph Banks appointed Edward Harrison, who would later try to reform medical practice in Britain, as the first physician to the Horncastle Dispensary in 1789. See Irvine Loudon, “Harrison, Edward (bap. 1759, d. 1838) rev.,” ODNB (Oxford: 2004), online edition, May 2007,

  33. 33.

    Ian Porter, Alexander Gordon, M.D. of Aberdeen (1752–1799) (Aberdeen: 1958), 47. It seems that Gordon himself was organizing the instruction.

  34. 34.

    Porter, Gordon, 27.

  35. 35.

    Proposals for a More Effectual Mode of Administering Medical Assistance to the Sick Poor in the Town of Liverpool (n. pl: 1774), pamphlet from the Liverpool City Library. I thank the library for assistance. See also Ulrich Tröhler, “The Doctor as Naturalist: The Idea and Practice of Clinical Teaching and Research in British Policlinics, 1770–1850,” Clio Medica (1987–8) 21:21–34.

  36. 36.

    Bronwyn Croxson, “The Public and Private Faces of Eighteenth-Century London Dispensary Charity,” Medical History (1997) 41:127–149.

  37. 37.

    Lucas, “Remarks on Febrile Contagion,” London Medical Journal (1789) 10 no. 3:260–76, on 273. This was reprinted in full in The Gentleman’s Magazine (1790) 60, pt. 2:731–3 and 835–7 because it was “so deserving the attention of readers of every class.”

  38. 38.

    Loudon, “Dispensary Movement,” 332.

  39. 39.

    John Ferriar, “The Epidemic Fever of 1789 and 1790,” in Medical Histories and Reflections, vol. 1 (London:1792), 172.

  40. 40.

    Lucas, “Remarks,” 261–2.

  41. 41.

    Charles Creighton, A History of Epidemics in Britain (London: 1965), 2:160. See also S. T. Anning, “Leeds House of Recovery,” Medical History (1969) 13:226–36. Anning does not mention Lucas.

  42. 42.

    Porter, Alexander Gordon, 23–6. Gordon offended local midwives by publishing an article that claimed some of them had carried puerperal fever to their patients.

  43. 43.

    See also M. C. Buer, Health, Wealth and Population, 200. This was probably James Ogden, listed by Peter John Wallis, Ruth Wallis and T. D. Whittet, Eighteenth Century Medics: Subscriptions, License, Apprenticeships (Newcastle: 1988) as a surgeon of Ashton (1760–a[fter]1805) and probably the doctor named in G. Tomlinson, A Letter to Mr. Ogden, Surgeon in Ashton-Under-Lyne Relative to the Case of Elizabeth Thompson upon whom the Caesarean Operation was Lately Performed (Manchester: 1799). In 1824, residents of Ashton wrote to the Medical Advisor and Guide to Health and Long Life, ed. Alex Burnett (London: 1824), 1:428 defending James Harrop who had been accused of quackery. They noted that he had been trained by James Ogden, MRCS, a surgeon of that town. He should be distinguished from James Ogden cotton spinner, poet and author of A Description of Manchester and other works.

  44. 44.

    John Ferriar, “Account of the Establishment of Fever-Wards in Manchester,” Medical Histories and Reflections, vol. 3 (1798), 43–92, on 44.

  45. 45.

    This building resulted from the infirmary meeting of June, 1790. See Chapter 7.

  46. 46.

    John Ferriar, “Of the Prevention of Fevers in Great Towns,” Medical Histories and Reflections, vol. 2 (1795), 209–10.

  47. 47.

    John V. Pickstone, Medicine and Industrial Society: A History of Hospital Development in Manchester and Its Region, 1752–1946 (Manchester: 1985), 23.

  48. 48.

    See the seminal chapter entitled “The Anti-Typhus Campaign and the Fever-Hospital Movement,” in M. C. Buer, Health, Wealth and Population, 193–209. Though his son became an Anglican clergyman, Bayley was a member of one of Manchester’s well-established Dissenting families. He attended Edinburgh and became a follower of John Wilkes, even proposing marriage to his daughter. After returning, he joined the Salford JPs and became the chair of the quarter sessions. A founder of the Manchester Literary and Philosophical Society, he also served as a trustee of Warrington Academy and the Unitarian Cross Street Chapel in Manchester. The Salford JPs heard Manchester’s criminal cases and administered the local House of Correction, which Bayley rebuilt. See Margaret DeLacy, Prison Reform in Lancashire, 1700–1850 (Stanford: 1986), 70–83; 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), 165–184.

  49. 49.

    The best published account (of many) can be found in W. P. Povey, “The Manchester House of Recovery 1796,” Transactions of the Lancashire and Cheshire Antiquarian Society (1987) 84:15–45.

  50. 50.

    Information concerning him is extremely sparse. Chris Meadowcroft, “The Meadowcroft and Lang Ancestors Pages,” gives his dates as 1756–1830.

  51. 51.

    New Manchester Guide (Manchester: 1815), 57.

  52. 52.

    “The Parish of Prestwich with Oldham Pilkington,” in A History of the County of Lancaster, ed. William Farrer and J. Brownbill, vol. 5 (Victoria County History), 88–92, online from British History Online at; “Members,” Memoirs of the Manchester Literary and Philosophical Society (1798) 5 pt. 1. The Swedenborgian New Jerusalem Church was in Stand Lane in Radcliffe, very near Meadowcroft’s home in Pilkington. On Clowes, see Paul Kléber Monod, Solomon’s Secret Arts (New Haven: 2013), 267–9.

  53. 53.

    The Swedenborgian abolitionist Carl Bernhard Wadström invested in a Manchester cotton factory, but the factory failed and Wadström emigrated to France in 1795. It is likely that he knew Bayley and Meadowcroft, but I have no evidence on this. See Robert William Rix, Blake and the Cultures of Radical Christianity (Farnham, UK: 2007), 92–3, 101–4; Rix, “Carl Bernhard Wadström (1746–1799),” written for Brycchan Carey’s website at See also Monod, Solomon’s Secret Arts, 301–2.

  54. 54.

    Morton D. Paley, Apocalypse and Millennium in English Romantic Poetry (Oxford: 1999), 37. See also Rix, Blake. Derek Antrobus outlined a vegetarian tradition connecting Jacob Boehme, Thomas Tryon, William Law, George Cheyne and John Byrom. Byrom influenced John Clayton (1709–73), schoolmaster, early friend of Wesley and vicar of Sacred Trinity Chapel in Salford, and his cousin Joseph Clowes, the father of the Rev. John Clowes (1743–1831). Byrom, Clayton and Joseph Clowes were all Tory Nonjurors. “England: 19th Century Roots of Vegetarianism,” Talk to the Salford Local History Society (1998), published by the International Vegetarian Union,

  55. 55.

    Carl Theophilus Odhner, Annals of the New Church with a Chronological Account of the Life of Emanuel Swedenborg, vol. 1: 1688–1850 (Bryn Athyn, PA: 1904), 129, online from Google. John Clowes, member of an extremely wealthy Lancashire family, remained an Anglican. Led by Painite curate, chemist, vegetarian and medic William Cowherd, members of Clowes’ congregation had seceded in 1793 and later formed the Bible Christian Church. Cowherd was succeeded by Joseph Brotherton.

  56. 56.

    Proceedings of the Board of Health in Manchester, preface (London: 1805), 181 and 186, online from the Internet Archive.

  57. 57.

    Proceedings of the Board of Health, 199. Percival and Bayley also served as chairmen.

  58. 58.

    Proceedings of the Board of Health, 4.

  59. 59.

    Proceedings of the Board of Health, 7–11.

  60. 60.

    Proceedings of the Board of Health, 5.

  61. 61.

    Ferriar, “Account of Fever-Wards,” 49.

  62. 62.

    Ferriar, “Account of Fever-Wards,” 59.

  63. 63.

    Ferriar, “Account of Fever-Wards,” 54.

  64. 64.

    Ferriar, “Account of Fever-Wards,” 53.

  65. 65.

    Proceedings of the Board of Health, 26–33. See also Povey, “House of Recovery,” 25.

  66. 66.

    The other staff members of the committee who signed were Mr William Simmons, Mr John Bill, Dr Alexander Taylor, Mr Michael Ward and Mr Gavin Hamilton. See Edward Mansfield Brockbank, Sketches of the Lives and Work of the Honorary Medical Staff of the Manchester Infirmary…1752–1830.… (Manchester, 1904); Webster and Barry, “Manchester Medical Revolution,” 173. William Simmons, surgeon and man-midwife, competed with the Whites for Manchester’s obstetrical business (see Chapter 7) and would cause further turmoil among the staff. Bill, Taylor, Ward and Hamilton became surgeons to the infirmary in 1790 after the resignation of the old staff, including the Whites.

  67. 67.

    On Percival’s “accomplices” as members of the Manchester Literary and Philosophical Society, see Webster and Barry, “Manchester Medical Revolution,” 171–2.

  68. 68.

    Webster and Barry, “Manchester Medical Revolution,” 172.

  69. 69.

    Bardsley’s Medical Reports of 1807 include important articles on diabetes (based on chemical experiments he did with Charles Rochemont Aikin and John Dalton) and rabies. He argued that rabies, like syphilis and smallpox, was caused solely by the introduction of a specific virus into the animal system and recommended quarantine.

  70. 70.

    Proceedings of the Board of Health, 45.

  71. 71.

    Proceedings of the Board of Health, 45–6. This passage is also quoted in Henry Harris, “Manchester’s Board of Health in 1796,” Isis (1938) 28:26–37. Harris states that the doctors were “Stressing spread by personal contact rather than by air, a subtlety not appreciated a century before the discovery of fleas and lice as typhus vectors,” but this issue was a crucial one in this period although the argument was over whether contagious diseases could spread in the air over any appreciable distance, not whether they could spread through the air at all. Even the most fervent contagionists accepted transmission by what we would now call droplet infection.

  72. 72.

    Proceedings of the Board of Health, 51.

  73. 73.

    Ferriar, “Account of Fever-Wards,” 68. There were to be a head nurse and three ordinary nurses, with additional nurses to be hired as needed.

  74. 74.

    Ferriar, “Account of Fever-Wards,” 68–9.

  75. 75.

    J. V. Pickstone and S. V. F. Butler, “The Politics of Medicine in Manchester, 1788–1792: Hospital Reform and Public Health Services in the Early Industrial City,” Medical History (1984) 28:22–49, on 244.

  76. 76.

    Povey, “House of Recovery,” 27–8.

  77. 77.

    Proceedings, 81–2; Povey, “House of Recovery,” 29.

  78. 78.

    Proceedings, 83–5. On Hay, who would be held partly responsible for the behavior of the yeomanry at Peterloo, see Povey, “House of Recovery,” 29, and many references in Robert Walmsley, Peterloo: The Case Reopened (Manchester: 1969).

  79. 79.

    “Copy of a Letter from Dr. Carmichael Smyth to Dr. Percival; dated London, 7th. July, 1796,” Proceedings of the Board of Health, 72. Carmichael Smyth (1741–1821, MD Edinburgh 1764), a licentiate and a member of the Society for Promoting Medical Knowledge was a protégé of Fothergill’s. He had become an FRCP speciali gratia in 1788.

  80. 80.

    “Copy of a second Letter from the same [J. Carmichael Smyth] to Dr. Percival. London, Aug. 1st. 1796,” Proceedings of the Board of Health, 74–6.

  81. 81.

    “Copy of a Letter from Dr. Haygarth, of Chester, to Dr. Percival, March 5, 1796,” Proceedings of the Board of Health, 65–6. Fumigations finally drew a scathing review by Thomas Trotter, who persuaded most doctors of their inefficacy.

  82. 82.

    Copy of a Letter from David Campbell, of Lancaster, to Dr. Percival, March 7, 1796,” Proceedings of the Board of Health, 67–71.

  83. 83.

    “Extract of a Letter to Dr. [Thomas] Percival, from Robert Percival…August 1, 1796,” Proceedings of the Board of Health, 77–9. I have not traced any family relationship between Thomas and Robert, but they were good friends. Thomas thanked Robert in his Medical Ethics.

  84. 84.

    The observations of Bruno Latour about the collective nature of facts, the mobilization of allies, the extension of networks and the accusation of irrationality used against any group that stands in the way are all germane to this conflict. See Science in Action (Cambridge: 2003).

  85. 85.

    Proceedings of the Board of Health, 105, 110.

  86. 86.

    In addition to Bayley and Percival, several other participants were members of the Unitarian Cross Street Chapel. For example, the first committee named to manage the House of Recovery included congregants Samuel Marsland, a mill owner; James Touchet, a merchant; Nathaniel Heywood, a banker (and Percival’s son-in-law); and the congregation’s minister, Thomas Barnes. See Thomas Baker, Memorials of a Dissenting Chapel (London: 1884). Both the Anglican Clowes and a Catholic Minister, Rowland Broomhead, were also members of this committee of 21, as were the infirmary physicians. The role of manufacturers and merchants deserves additional analysis.

  87. 87.

    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, on 113.

  88. 88.

    Ditchfield, “Test and Corporation Acts,” 114.

  89. 89.

    Povey, “House of Recovery,” 18.

  90. 90.

    Proceedings of the Board of Health, 88.

  91. 91.

    Proceedings of the Board of Health, 88–9. The act was 29 George II c. 8.

  92. 92.

    Proceedings of the Board of Health, 89.

  93. 93.

    Proceedings of the Board of Health, 89.

  94. 94.

    This view returned in the nineteenth century even for typhus. For example, in 1846 an Irish physician, Dominic Corrigan, published Famine and Fever as Cause and Effect in Ireland, claiming that Irish epidemics were the result of famine, not contagion or personal hygiene. Although distinguished physicians opposed his theory, Corrigan became a commissioner of health in Ireland the same year. E. Margaret Crawford writes that this led some hospitals to mix typhus patients with others in large wards and that this contributed to the spread of typhus during the famine. See her “Typhus in Nineteenth-Century Ireland,” in Medicine, Disease and the State in Ireland, 1650–1940, ed. Elizabeth Malcolm and Greta Jones (Cork: 1999), 121–37, on 130–2. Charles Dickens reflected this more miasmatic view when he wrote that “there were in Manchester…and one or two other towns…houses of reception for fever cases…based on a more limited sense than we now have of the cause of typhus. All that had to be done in the way of drainage and construction of dwellings was very dimly recognized, but the belief stopped at the fact that infection rather spread from person to person than that it arose in the same way among many persons exposed to the same noxious influence.” Charles Dickens, “Growth of a Hospital,” All the Year Round (August 10, 1861) 5:476.

  95. 95.

    Pickstone, in Medicine and Industrial Society, 26 wrote that Percival’s group opposed contagionism: to them, “the common fear of the contagion of fever was misguided. The theory that the air was generally tainted, or that any approach to the sick was dangerous, increased apprehension and restricted salutary action. Fear of contagion seemed to be increasing during the 1790s; the Board of Health collected their many reports to counter-attack.” This is misleading. The dispute was about whether contagion, seen as a material substance distinct from a “general taint of the air,” was well enough understood to be managed, not about whether it existed. As we have seen, Percival’s group was more, not less, wedded to strict contagionism than their opponents.

  96. 96.

    Proceedings of the Board of Health, 96.

  97. 97.

    White’s wife was the daughter of the high sheriff of Lancashire and the granddaughter of the bishop of Chester. The board refers only to “Mr. White,” but Charles’s son and partner Thomas White had died in 1793.

  98. 98.

    Charles James Cullingworth, Charles White F.R.S. (London: 1904), 44. Peter Holland had studied with Aikin in Warrington. He became a Knutsford surgeon and the father of Sir Henry Holland MD (see Chapter 4 above). Among his relatives were Wedgewoods, Gaskells, Darwins and Sydney Smith.

  99. 99.

    In 1809, White threatened to sue Holland for breaching the terms of his apprenticeship, which barred him from practicing medicine within 10 miles of Manchester. Henry Holland wrote Lucy Aikin that the incident was a “conspicuous instance of malevolent feeling” by White. John Chapple, Elizabeth Gaskell: The Early Years (Manchester: 1997), 145. See also Chapter 7.

  100. 100.

    Proceedings of the Board of Health, 124.

  101. 101.

    Proceedings of the Board of Health, 143.

  102. 102.

    Povey, “House of Recovery,” 34–6.

  103. 103.

    Povey, “House of Recovery,” 37.

  104. 104.

    Proceedings of the Board of Health, 148.

  105. 105.

    Proceedings of the Board of Health, 188. Arthur Redford, The History of Local Government in Manchester, vol. 1, Manor and Township (London: 1939), 181, calls Manchester’s parochial officers at the end of the century “a slack and incompetent set of High Church Tories.” If their party affiliations were widely known, their tacit endorsement would have been especially welcome.

  106. 106.

    Proceedings of the Board of Health, 196–7.

  107. 107.

    Proceedings of the Board of Health, 196.

  108. 108.

    A good brief history is the section for the “Metropolitan Asylums Board” in Geoffrey Rivett’s National Health Service History website at Many of Rivett’s sources, including the reports of W. H. Power, are online. See also Michael Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865–1900 (Cambridge: 2000), 211.

  109. 109.

    The board meeting of 1800 also resolved to create a separate ward for patients suffering from sore throat and scarlet fever.

  110. 110.

    James Currie, Medical Reports on the Effects of Water, Cold and Warm, as a Remedy in Fever and Other Diseases, 4th edition (London: 1805), 1:362, dated n.

  111. 111.

    A Dissertation on the Source of Epidemic and Pestilential Diseases (Calcutta: 1797), rpt in London as The Plague Not Contagious.… (London: 1800). See also Catherine Kelly, “ ‘Not from the College, but Through the Public and the Legislature’: Charles MacLean and the Relocation of Medical Debate in the Early Nineteenth Century,” Bulletin of the History of Medicine (2008) 82: 545–69.

  112. 112.

    The (first) Factory Act of 1802 regulated the working hours for children, required that they had access to instruction, and created rules for maintaining ventilation and sanitation in the factory buildings. The Manchester and Salford Police Act of 1792 had also named commissioners with the power to raise rates, superintend night watchmen, and arrange for street cleansing, street lighting, street drainage and highway maintenance. Historians have offered mixed accounts of its implementation.

  113. 113.

    Thomas Bernard, “Extract from an Account of the Institution to Prevent the Progress of the Contagious Fever in the Metropolis,” in Bettering Society Reports, ed. Thomas Bernard (1802) 3:202–15.

  114. 114.

    John Coakley Lettsom wrote dozens of these. They were collected by his friend John Nichols into three volumes and published as Hints Designed to Promote Beneficence, Temperance and Medical Science (London: 1816).

  115. 115.

    Thus the account of the Manchester Infirmary disputes by Pickstone and Butler, “Politics of Medicine in Manchester,” provides an illuminating dissection of the medical rivalries of the period and the political, social and religious fissures that they reflected, but it ends before the Manchester House of Recovery opened and does not analyze the influence of contagionism. In his later book, Medicine and Industrial Society, 26, Pickstone comments that “The Fever Hospital was not established without a fight” but dismisses the objections of opponents in a few sentences, implying that its creation was inevitable. Prolonged battles and frequent setbacks for similar institutions show that this was a hard-won victory.

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DeLacy, M. (2017). Institutionalizing Contagionism: The Manchester House of Recovery. In: Contagionism Catches On . Palgrave Macmillan, Cham.

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