Editor’s note: Born in 1903 in East Anglia, Thomas Ownsworth Garland was sent away to boarding school at the age of seven, an experience that left him with a keen dislike of public school and of the elitism and brutality that helped to fuel it. As a student at Cambridge, he initially distinguished himself as a rugby player, until a bout of tuberculosis in 1928 led to his confinement at Mundesley Sanitarium. “I seem to have been ill in all my jobs a proportion of my time,” he would later reflect. “Illness, however, time and again provides time for thinking. Most don’t have that opportunity”.
That experience of near-fatal illness led him to undertake a career in medicine. Around 1930 he began working as a doctor aboard the SS Morton Bay, treating men and women en route to Australia and South Africa; then, back in the UK, he bought a horse-drawn caravan and conducted an itinerant practice around the midlands and south-east England. That exposure to the realities of poverty led him to join the Communist Party. Though he left the Party in 1946 (the same year in which he emigrated to New Zealand), he remained a radical socialist all his life. He died in 1993 after a distinguished career in occupational medicine.
Two years ago, in sorting through his father’s papers, Garland’s son Nicholas unearthed a Master’s thesis Thomas Garland completed in 1938 for Cambridge University, titled “A Study of Anxiety and Physical Stress Among Factory Girls”. It was based on observations of industrial ailments amongst young female factory workers that he had recorded while serving as medical officer for the Carreras Cigarette Factory in north London. In this, our first Long Read article, Sally Alexander explores Dr Garland’s remarkable thesis, examines the lives and conditions that it documents, and reflects on the striking mix of insight, compassion, and outrage with which he infuses it.
Many thanks to Nick Garland, Daniel Pick, and the staff of the Wellcome Library, where Thomas Garland’s thesis has now found a permanent home.
Thomas Garland was a young newly qualified doctor who knew nothing about either industrial illness or factory work when from 1933 to 1937 he worked as medical officer to the new and ‘glamorous’ Carreras Cigarette and tobacco factory in Camden Town, one of London’s Victorian industrial districts. Written principally from his case notes – a hybrid of medical practice with social observation – his study shows how working conditions in the Carreras factory wreaked deleterious effects on the young women’s physical – more especially their mental – health. ‘Speed-up’, piecework, untrained and unregulated supervision, a punitive fines system applied for lateness, absence, ‘answering back’, talking to each other – anything which interrupted the flow of assembly line (known as ‘swinging the lead’ in shopfloor parlance) – fueled chronic anxiety and ‘nerves’. A cluster of debilitating symptoms – nightmares, insomnia, indigestion, giddy attacks, headaches, palpitations, rheumatism, anorexia – forced the young factory worker off the shopfloor, sometimes for days or weeks at a time with much feared loss of earnings. ‘Only rarely did the girl have any understanding of her difficulties’ Garland remarked, or any idea why she felt the way she did, since, as he was often told, ‘she had no wants or worries’.
Garland’s study, his detailed case notes (there was no time for him to take full case histories, since like his patients he worked against the clock) are of value to the historian for several reasons. Written during the 1930s against the backdrop of worldwide economic recession, in the wake of the collapse of the second minority Labour government (which fell through cuts in benefits to the unemployed, and the despised household Means Test) the study throws light on the development of modern industry in London during the years of its unprecedented growth. Machinery and profits drove the labour process not human labour and need, Garland argues. Conversations with the stricken young women workers who visited his sick room led Garland directly from the work discipline of a modern factory to the intimate realities of family life among some of London’s poorest families. Garland listened as he encouraged his young patients to describe in their own words their symptoms and feelings, to write down their dreams in the attempt to probe their silence, to awaken their imagination to the images and dream thoughts which underpinned their fears. His patients’ dream life – he recorded 140 dreams – enables the historian to read into young women’s bruised subjectivity a fractured dimension of historical democracy: their symptoms could be seen as small acts of protest – personal, individual – but historical protest nonetheless.
The former Carreras factory still exists today in Mornington Crescent, a recently renovated icon of British modernism. It stands between the busy Hampstead Road and the scrap of land in front of the social housing opposite. Ill health was built into the factory’s foundations. Eight hundred men took eighteen months in 1926-7 to construct the new factory to an architect’s specifications over the gardens which until then had breathed fresh air and light into Mornington Crescent’s elegant terrace of houses. An Egyptian façade (inspired by the discovery of Tutankhamun’s tomb in 1925), fronted by two giant black cats (the firm’s trademark) built with reinforced concrete housed five floors of marble staircases leading to whitewashed offices, corridors and shopfloors fitted throughout with automated machinery. The factory was the first in London to introduce air conditioning and dust extraction, as well as the timed, ‘speeded up’ labour process which made the jobs perilous. Between 3 and 4,000 workers most of whom were young women were employed there. Carreras (a west end firm founded by a Spanish migrant in the late nineteenth century) used every marketing ploy; it sold handmade ‘monogrammed’ cigarettes for the ‘gentry’ – ‘Coloured cigarettes for the ladies, with the gold tips’, according to Ann Joseph who worked there in the office and front of house for five years during the 1930s and who I interviewed in 1977. The work was hard but because it paid high wages and produced luxury goods which it sold through its own outlets, working there you felt ‘a cut above’.
Cigarettes and tobacco were one of Britain’s ‘new’ growth industries in the early twentieth century. The 1920s and ‘30s were decades of economic restructuring between two world wars. Britain was striving to hold its own as a world imperial power amid the rise of fascism and movements of national liberation among former colonies. ‘Light’ manufacturing industries destined for the domestic market – food processing, wirelesses, batteries, light engineering, chemicals, cinema and cigarettes – were located throughout London’s industrial districts already clustered with furniture, clothing, print and paper and a miscellany of other workshop and factory trades. These new manufactures employed cheap female labour whose youth, inexperience, and ample supply enabled employers to introduce new production processes: conveyer belts, assembly lines, and extra supervision based on Adam Smith’s principle of division of labour, accelerated by time and motion studies, powered by the electric grid without sustained trade union opposition or regulation. ‘Dilution’ in the munitions industries during the first world war had been the forcing ground of these new methods and women workers were its shock troops. Garland’s young women patients – leaf strippers, packers, machine handlers, tray examiners from three departments – were as vivid a sign of mass production in modern industry as the conveyor belt and assembly line; they were the vulnerable other side of J B Priestley’s ‘factory girls looking like actresses’. They were also the daughters and sisters of unemployed men – oyster sorters, wharfingers, tailors for example – and they changed the face of the working classes.[1]
The economic history of the interwar years is often told as two simultaneous if distinct regional and economic narratives. On the one hand, Britain’s staple export industries – coal, steel, engineering and shipbuilding – situated primarily in the north and borderlands had been stagnating since the 1920s for reasons including the wartime disruption of overseas markets, the stalling of postwar reconstruction, the destabilizing effects of colonial liberation movements, return to the Gold Standard (1926), and the Wall Street Crash (1929). These were the ‘distressed districts’ whose labour force, with the exception of textiles, was mostly skilled and unskilled men who were subjected to long spells of unemployment. Meanwhile, new light industries dotted around the periphery of Britain’s towns and cities, in industrial estates, connected by new arterial roads and motor transport galvanized new mass markets, fuelled by cinema, advertising and a new young labour force.
Garland’s study muddies these economic distinctions and geographical boundaries. London’s vast growth, its complex and diverse economic structure, included both ‘old ‘and ‘new’ industries (and much more besides). Shipbuilding, once a flourishing industry of the Port of London which reached for twenty miles both sides of the river towards Tilbury, was in decline, but engineering, dock labour with its associate trades, transport and construction spread through London’s eastern riverside boroughs which together with the populations of London’s east end supplied labour throughout the city in these decades. Few workers in London’s trades and industries – in whatever sector – could rely on regular employment. Throughout the Greater London economy work was seasonal, often casual and short time work was common; conditions in the burgeoning ‘white collar’ and service sectors (offices, shops, dance halls, cafes and cinema for instance, filled with young women workers) followed suit.[2] As Garland noted, everyone knew about the ‘distressed districts’ whether through their own family histories or from migrant workers who poured into London in search of work.[3] His case-notes with their focus on the individual and her family reproduced economic divisions in close-up; homes, in Garland’s study, were a microcosm of the national economy.
Garland’s young patients told him of fathers, mothers, and brothers out of work, whole households forced to rely on the young women’s wages – which were a fraction of what a skilled man could earn when employed. Girls came straight from school, without training or preparation, to work a sixty-hour week in Carreras including compulsory overtime, because families – reduced to ‘bare essentials’ – needed their earnings and the employers worked them to the limits of the law.[4] Whole streets and squares around the factory were filled with families of two generations who worked in the factory. But because Carreras had a reputation as a ‘high wage’ factory – it paid better than either the hated (by London girls) domestic service or jam or leather factory work in the riverside boroughs, a fact with which malicious supervisors used to taunt the girls – hundreds of young women came from further afield. They rose at five or six in the morning to travel several miles from Dagenham or Canning Town in the north-east of the County in crowded trams, without breakfast, adding an hour or more to the working day – an experience which ‘generated a sense of injustice’. Long hours with only a ten-minute break in the morning, an hour for lunch, plus an hour or more’s travel there and back were the principal causes of stress, strain, ‘nerves’ which eventually undermined already weak and undernourished young bodies and minds.
The fourteen- to sixteen-year-old handed her wage straight over to her mother who gave back a few pence for fares and lunches (seldom enough to pay for the canteen lunch every day), a custom which might continue into the young worker’s twenties. Case 24 for example, aged sixteen, from Dagenham in East London, suffered from ‘minor ailments’. The eldest of six children (the youngest aged five) handed her wage over to her mother. Her father was a labourer, ‘usually unemployed’; her mother ‘goes nursing whenever she can’. When she returned from work she was – like many others – expected to clear up, wash and feed the children, on top of her long working day. ‘In the early part of my investigations’, Garland writes, ‘the difficulty seemed to be to pick out any immediate cause of symptoms common to many of the girls. When I traced far enough back, however they nearly all led back to economics’. Fear of not ‘earning her money’ when her family depended on it made the young worker ill. ‘(T)he girl today although unmarried and without children’ Garland continued, ‘may yet find herself the chief wage-earner of a whole family…there are thousands of girls in Britain today.’
Thomas Garland’s work as a medical officer required him to interview and examine the health and circumstances of every new employee, as well as absentees from the shop floor. Every factory worker who was taken ill, reported sick, or who took time off work was seen by him, whether she was referred by a forelady or chargehand or found her way to his sickroom herself. Those who lost several days’ work saw the Panel doctor in the hope of obtaining a medical certificate to avoid loss of pay. (This was a local GP who – except in charitable cases – charged a small fee.) During his 4 years as MO Garland estimated that he met and treated over a thousand young women and some men – about one third of the workforce. He fitted 5000 consultations into the three years from 1934 to 1936.
Treatment consisted of conversations continued through several weeks or very occasionally months. If the symptoms had no physical cause Garland asked questions, made suggestions, offered advice or an insight – ‘discussions’ we can follow through the case notes. He used a ‘more or less stereotypical series of questions’ to save time and to loosen tongues, which usually worked except when ‘the mind of the patient seems to go completely blank’. He believed in time and thought. Sometimes a domestic adjustment lessened symptoms, as with the young woman mentioned above (case 24), who moved out of her parents’ home to live with her aunt and husband nearby for the winter. Her aunt did not welcome the addition to the household, nevertheless families and kin often provided fluid support within neighborhoods. Others made an insight or suggestion from Garland their own over time; in this way a young woman might recover the courage – despite her fears – to go dancing or to the cinema again with her girlfriends, or to meet her ‘boy’. [5]
Relations with ‘boys’ figure in almost every case-note. The content of Garland’s medical education is not given, but his interest in ‘sex lives’ is everywhere evident. He devotes a section of the Study to the ‘obstacles to marriage’. The ‘long wait’ for marriage, he thought, placed enormous strain on the young women (and their ‘boys’, for whom he reserves a particular empathy). The Carreras factory, like most ‘new industries’ in the interwar years, had a marriage bar. Some couples were ‘engaged’ for several years inducing what Garland named ‘the dreariness of habit’. Young people could not afford to marry, the young woman could not sacrifice her wage, ‘she may earn more than her boy’. Of more concern were the many whose ‘loathing’ of physical contact, ‘dread’ of intimacy, ‘indecency’ or even marriage itself was manifest in a refusal to conceive of sex or sexual intercourse at all, a gap or silence filled by a ‘sense of sin’ or fear of pregnancy; sentiments instilled – in their own account – by observation or ‘what they had been told’.
Case 45 for instance, aged twenty, stands for several. She had been engaged for four years to a boy who was a collar-cutter. This patient (unnamed) had the feeling that ‘women are injured by men as far as her mother and father are concerned’. She visited Garland with pains along her neck and arms, ‘feeling very depressed’ … ‘gone to bits’. This was the third time she’d ‘been out’ this year. She lived alone with her mother who, after two weeks in hospital with an injury inflicted by her husband, ‘got a separation’ from him; he now paid the mother 6/- a week (about 30p). When he lived with her mother he was ‘a drunkard who was always knocking her about’.
Garland encouraged his patients to describe, to write down in their own words, the content of their dreams and nightmares and then to associate around what they had written or said. The effect is shocking, moving and difficult to read. Young women tell complex dreams of murder, bodily violence and mutilation which invoked feelings of terror, persecution and suspense, resentment and more which blended with their waking thoughts even as they declared that they could think of no reason why they had panic attacks, felt depressed, ‘in bits’, paralyzed or wracked with anxiety, found lumps and sores all over their bodies or were unable to stop weeping. The nightmares of the young woman above, for instance, Case 45, disclosed a sequence of sudden and cruel mutilations, a house on fire, her mother crawling upstairs towards her on her hands and knees, scenes of horror which – Garland with the young woman together eventually worked out – masked fears of being sent away from home; on a previous occasion she had been isolated in a convalescent home.[6] Further conversation revealed her sense of persecution by her forelady Daisy White, who she believed, watched her constantly – a common fear; other dreamers were spied through a spyglass, watched by a policemen hidden in the bushes, and more. If she so much as looked around or said, ‘good morning’ she ‘looked me up and down as if I had done a murder’. Not being allowed to speak to anyone made her miserable, she explained. ‘If you are alone with your thoughts all day long I don’t think it does you any good’ – she ‘let out a long wail’.
If the dreams scenes compressed hallucinatory violence (murder, mutilation or other forms of arbitrary violence) or incorporated the uncanny (perpetrators were often mothers or sisters), then settings and props were often familiar: overcrowded houses, walks, holiday venues; attackers made use of choppers, daggers. rifles, lumps of wood, or pencil sharpeners to pierce or cut away limbs. Principal actors were familiar too, repositories of the dreamer’s projected (?) fear and guilt: siblings, the subject’s ‘boy’, foreladies, or, occasionally, Garland himself. Elsie, aged 24, dreamt of Garland cutting her open to get at her heart:
I was in hospital, and was being wheeled up and down a steep hill it seemed. I was laid on an operating table, and the doctor attending me was stabbing me slowly with a dagger, he was going to cut my chest open to look inside. I was struggling and screaming to get away, but my sister would hold me down.
Struggling to ‘get away’, to take flight, figured in several young women’s dreams, as well as in their sleep ‘wanderings’. Some dived off the bed, leapt into a boat, wandered from house to house – to escape feelings of lust, terror, or their mother’s predatory wrath. Mothers, siblings and supervisors aroused aggressive, vengeful feeling in dreams and hallucinations because their rules and strictures governed the everyday. Elsie’s associations led her to a holiday she had spent in the highlands with her boy. ‘The doctor was myself’, Garland infers ‘and the terror was inspired by fear that when the chest was open her affairs of the heart would be open too’. On that holiday Elsie first had sexual intercourse she told Garland.
The strict and sexually differentiated moral universe Garland’s young patients inhabited mirrors the one carefully reconstructed by historians Kate Fisher and Simon Szreter, who use spoken memory to demonstrate wonderfully how erotic pleasure and satisfaction could be enjoyed despite moral hazards. Garland too, the reader senses, was on the side of small pleasures .[7] Not every experience was grim. There were ways of negotiating the perils of work discipline, family poverty and moral strictures which did not make the young women ill he learned from his patients – as well as his research. He sought out and reproduced the testimony of one former chargehand who spoke frankly and wisely about how to survive working ‘at the bench’: she ‘thought for (her)self’, ‘moulded myself on those I had worked under’ and stood up to bullying supervisors. Small shifts in understanding were affirmed by the young women themselves. One girl ‘cheered up’ after talking about ‘the madness related to periods’, another expressed wonder at the ‘power of conversation’, while another relished the task of writing down her own dream life. Every case reveals Garland’s respect and reasoning compassion for his patient’s plight and feelings, his recognition of the several causes of their distress. He encouraged human thought as a source of resilience and recovery, and he placed hope for improvement of ruthless factory working conditions in the power of law.[8]
Garland situates his study in what was then the developing field of industrial fatigue and welfare. Knowledge about the ill effects of working conditions was pioneered in the seventeenth century by Dr Ramozinni in Modena, curious about the effects of employment on workers in the local cesspool. Until the early twentieth century the only known industrial diseases, Garland tells us, were those listed under the Workmen’s Compensation Act, which in fact had a long history in the early factory reform and trade union movements (and workers themselves could have named more). [9] Early twentieth century studies of industrial disease among lead workers, telegraphists, and miners (in the cramped, dark, flooded conditions underground; a thousand miners died every year) found anxiety and strain the common thread unpinning otherwise diverse symptoms particular to each trade. Garland visited other factories in pursuit of evidence, studied family budgets, read up on the recent history of neurosis, joined the scrummage for trams endured by some of his factory workers, drew maps of distances travelled, and kept lists of symptoms suffered, all of which fed into scientific papers that he delivered to industrial and medical audiences in order to raise awareness of the dangers to the ‘human factor’ of industrial work.
Garland’s research drew stark conclusions. Most of Britain’s 14 million industrial workers, he estimated, worked in hazardous unregulated conditions at risk of accidents, injury, industrial disease or even death without compensation with only two or three hunded Factory Inspectors then in existence to ensure safety regulations in every workshop. While physical dangers were lessening in some trades and occupations, new methods of modern industry increased mental strain. Working with a model of mental life divided into the conscious and unconscious and driven by sexual desire, Garland was also pragmatic. The factory worker who fell ill of nervous strain or breakdown was neither ‘neurotic’ nor ‘maladjusted’, as some doctors influenced by the new psychology argued.[10] Anxiety and dread were rational responses to dangerous working conditions driven by the automated speed of the conveyor belt and the employers’ greed for profits, conditions in which the human became an appendage to the machine – he quotes Friedrich Engels more than once. Industry must reform, Garland insisted, not the ‘fear driven worker’.[11]
Recommendations run through the text. Either young women should be allowed to work when married or male workers be paid enough to support ‘the standard of living’, compulsory overtime should be banned, one week’s paid holiday for everyone should be statutory (introduced in 1937 with exemptions), and town planning should ensure that factories were built close to appropriate housing. But Garland reserved his strongest plea for the creation of an Industrial Medical Service funded and administered by the Government, available for all workers. Garland’s Industrial Medical Service was one of several schemes that arose out of voluntary and civil servants’ explorations of health and welfare in London’s boroughs and neighbourhoods whose examined lives and habits were a prelude to the Beveridge Report in 1942. Their beliefs and hopes for a world free of war, unemployment and injustice crystallized in the landslide election of Clement Attlee’s Labour government in 1945 with its promise of a social service state, and their ideas fuelled the creation of the National Health Service eventually realised through the resolute determination and negotiating skills of Aneurin Bevan in 1948.[12]
Garland’s study was written against the backdrop of industrial depression and political conflict, when the British Labour movement debated class war, or more concretely whether collective bargaining or law reform would prove more effective in improving working and living conditions in the age of mass democracy.[13] As a vigorous endorsement of hope for the new discipline of industrial welfare, it suggests both the discipline’s strengths and its weaknesses. While Garland cites the Trades Union Congress’s 1932 report on the Bedaux system (timed speed up of the labour process), he is silent on trades unions. Neither does he mention the achievement of women’s suffrage for those over twenty-one in 1929 which intensified arguments throughout the trades unions and within the Labour Party over birth control and family allowances with their implications for equal pay – as well as the status of women at work and home. These were the domestic political tensions and context which – combined with the threat of world war – shaped both his local study of young women factory workers’ health and the uncomfortable political compromises which constituted British social democracy in Britain during the 1930s.
Garland’s study held work discipline, family poverty and the girl’s own fears in fine balance. His close attention places the London factory girls among the engineers, stevedores, tailors, labourers and others whose livelihoods were dislocated by unregulated modern industry during the nineteen thirties. He hoped for improvements from factory legislation, readers will be haunted by the young women themselves – Tilly, Amy, Daisy, Elsie, Annie, Aggie, Kitty and others – who voicing their dreads and needs in their own words were harbingers of times to come.
[1] S. Alexander, title essay in Becoming a Woman, Essays in 19th and 20thc feminist history, Virago, 1994. Selina Todd, The People, the Rise and Fall of the Working Class, 1910-2010, John Murrary, 2014, chs 4 and 5.
[2] For unemployment in London’s workshop trades, NSL, vol. 1, 353.
[3] Max Cohen, I was One of the Unemployed, Left Book Club, 1945, a migrant cabinet maker from the North gives a meticulous and searing account of the mental and physical effects of unemployment, on himself, his kin, as well as the effects of mass production – piecework, speedup in dangerous workshops – on his craft skills.
[4] Cohen, I was One of the Unemployed, p 57; see also p 234 where Cohen wonders how ‘girls were expected to live’ on their ‘pittance’ of a wage. The starting wage of young girl was approximately £1.50 pw, about half or a third of a man’s wage for equivalent work. A skilled young woman pieceworker at Carreras might earn twice that, though wages, like employment itself, were never regular. The New Survey of London Life and Labour, (NSL) vol.lX Life and Leisure, Part lV, ch Xlll, lll Bermondsey Housewives, 413-431. Re-armament from the mid-1930s unevenly set skilled and semi-skilled workers in engineering, shipbuilding, transport and munitions to work again.
[5] Ann Joseph danced in her lunch hour when employed at the Co-op in the early 1930s, Interview with author 1976. Welfare officers in factories encouraged dancing among young women workers from the mid-1920s, as for example in a large print works, where the girl card-sorters interrupted their monotonous, mechanical labour only with ‘beautiful crochet’ which kept them in the same ‘stooped position’ until dancing was introduced to liven them up, Annual Report of the Chief Inspector of Factories and Workshops, PP 1927, vol 9, p 66.
[6] London memoirs and oral histories of the period are filled with dread of being sent away. Forced isolation was common when the illness was infectious. Ann Joseph quoted above had an unspeakable time as a convalescent. She shared a bed with her mother in Stepney Green, London’s east end, until marriage, a common experience among the poorest London families – in the past and today.
[7] Kate Fisher, Simon Szreter, Sex Before the Sexual Revolution, Intimate Life in England 1918-1963, Cambridge, 2010.
[8] David Egerton, The Rise and Fall of the British Nation, A Twentieth-Century History, Penguin Books edn., 1919, chs 4 and 5 give a forensic account of the character of the businessman in the thirties, his close connection with both Houses of Parliament.
[9] The first Act was passed in 1923; opposed by the Labour Party because its terms favoured the employers. Factory reform and the trade union movements stem from the early 19thc. Sydney and Beatrice Webb, Industrial Democracy, 1897 is irreplaceable, and has a useful bibliography; see also H A Clegg, Alan Fox, and F Thompson, A History of Trade Unions since 1889, vol 1. 1964; Alistair J. Reid, United We Stand, A history of British Trade Unions, Allen Lane, 2004.
[11] Matthew Thomson, Psychological Subjects: Identity, Culture and Health in 20thc Britain, Oxford 2006, gives an indispensable account of the new psychology and its context; see also ‘for the ‘new psychological landscape that emerged out of the first world war,’ Peter Barham, Forgotten Lunatics of the Great War, Yale University Press, 2007, ppk. Edn.
[12] See for example Innes H Pearse, Lucy H. Crocker, The Peckham Experiment, a study of the living structure of society, George Allen and Unwin, 1943. Few London boroughs were without its mother and child or birth control clinic in the interwar years. Garland’s young women came from economic and social backgrounds similar to those documented in Maud Pember Reeves, Round About a Pound A Week, (1913), Virago 1979. Children in the Lambeth study are described as accepting disappointment.
[13] Hugh Armstrong Clegg, A History of British Trades Unions since 1889, vol 2 1911-1933, Clarendon Press Oxford, 1985, especially ch l4.
wonderful Sally!
A wonderful article, thank you
From the US (NYC): another wonderful piece of history, Sally. I am especially intrigued by the mixture of modern touches with classic 19th c. problems. Christine Stansell
This is such a fascinating article. What an illuminating source, and so beautifully written.