“The lodge-keeper admitted them into a great oblong yard, on one side of which were offices for the transaction of business; on the opposite, an immense many-windowed mill, whence proceeded the continual clank of machinery and the long groaning roar of the steam-engine, enough to deafen those who lived within the enclosure”
-Elizabeth Gaskell, North and South, 1855
The picture painted by Elizabeth Gaskell in works such as North and South of the industrial north and the dark mills of the 19th century is one that has become very familiar to most. But looking to original archival sources, what can some of the first-hand accounts of the period add to this? Within the Manchester Medical Manuscripts Collection there is one manuscript in particular that stands out as being distinctly relevant to this period of the region’s history. Created in 1843-5 by a prominent Manchester doctor, John Shepherd Fletcher (1822-1882), it recounts a number of individual cases seen and treated in the Manchester Royal Infirmary during his time as a medical student. What makes this manuscript grab the attention of the reader more so than similar records of cases seen in hospitals in other cities or from an earlier period is the high preponderance of industrial accidents suffered by adults and children alike found amongst the more commonplace ailments.
The effects of industry recorded by Fletcher did not go unnoticed at the time, for during the same years as Fletcher created this manuscript Friedrich Engels was in Manchester and what he saw during his time here led him to comment:
“Besides the deformed persons, a great number of maimed ones may be seen going about in Manchester; this one has lost an arm or a part of one, that one a foot, the third half a leg; it is like living in the midst of an army just returned from a campaign.”
-Friedrich Engels, The Condition of the Working Class in England, 1845

Fletcher usually reports each case in a very matter of fact way, as might be expected of a medical record recounting the facts of an injury and its treatment, but often gives some background information on the cause of specific injuries and an individual’s occupation. One of the cases Fletcher met with and treated alongside the Infirmary’s senior physicians was that of 13 year old Martha Felton whose case he introduces thus:
“Martha Felton age 13 works in the factory was admitted on evening of the second of Decr 1844 into the hospital under the care of Mr Jordan. She is a fresh lively looking girl with florid complexion & apparently of healthy constitution. Her previous general health has been good.
At about 7pm on the 2nd instance she was removing a strap off a roller when the machinery caught the fore arm a little below the elbow and completely severed it from the arm at about two or three inches below the elbow joint. The wound bled very freely immediately after the accident but this did not continue long.” [Ref: MMM/10/1]
Martha remained in the infirmary for three months during which time Dr Fletcher records her progress and bodily condition most of which focuses on how well the wound is healing, pulse, appetite, sleep, and with occasional references to levels of pain. She is discharged on 3rd March 1845 when her arm is described as ‘almost healed’ and Fletcher’s final comments are: “She was to have arm strapped & was made outpatient.”
This is just one of many cases, and not just of industrial accidents, to be found in this particular manuscript that were seen in the Manchester Infirmary but nonetheless remains a relatively small snapshot of the health of a population whose access to healthcare remained severely restricted.
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