Hektoen International

A Journal of Medical Humanities

North and South and the intersections of environment and health

Roslyn Weaver
Sydney, Australia


 Elizabeth Gaskell

Elizabeth Gaskell
Portrait by George Richmond, 1851

“Why, Mr. Thornton! You’re cutting me very coolly, I must say. And how is Mrs. Thornton? Brave weather this! We doctors don’t like it, I can tell you!”

“I beg your pardon, Dr. Donaldson. I really didn’t see you. My mother’s quite well, thank you. It is a fine day, and good for the harvest, I hope. If the wheat is well got in, we shall have a brisk trade next year, whatever you doctors have.”

“Ay, ay. Each man for himself. Your bad weather, and your bad times, are my good ones. When trade is bad, there’s more undermining of health, and preparation for death, going on among you Milton men than you’re aware of.”

“Not with me, Doctor. I’m made of iron. The news of the worst bad debt I ever had, never made my pulse vary. This strike, which affects me more than any one else in Milton – more than Hamper – never comes near my appetite. You must go elsewhere for a patient, Doctor.”

“By the way, you’ve recommended me a good patient, poor lady! Not to go on talking in this heartless way, I seriously believe that Mrs. Hale – that lady in Crampton, you know – hasn’t many weeks to live. I never had any hope of cure, as I think I told you; but I’ve been seeing her today, and I think very badly of her.”

Mr. Thornton was silent. The vaunted steadiness of pulse failed him for an instant. (256-7)1

 * * *

Elizabeth Gaskell’s North and South is a novel of contrasts: a juxtaposition of people and philosophies encapsulated by the geographical distinctions of the title. The north is represented by the “smoky, dirty” industrial town of Milton in the north of England (95), and the south by the idyllic Hampshire village of Helstone, with its “fresh and open air” (103). First published in serial form in 1854-5, North and South does not focus on illness per se, but its attention to location and to industry, and to the physical and mental wellbeing of the working class, inevitably prompts reflections on the occupational health difficulties that have haunted the history of industrialization.

When clergyman Mr. Hale moves his wife and daughter, Margaret, from Helstone to take up a teaching job in Milton, he is almost immediately assailed by doubts and fears about his family’s health because of the shock of the contrast between the two locations. Mrs. Hale’s maid Dixon prophesies doom, warning Margaret that “it will be your death before long” (75), and when their arrival to Milton reveals it to be a place of “smoke and fogs” (76) because of the industrial environment, Mr. Hale expresses his own fears that their new home will adversely affect his family’s health: “Margaret, I do believe this is an unhealthy place. Only suppose that your mother’s health or yours should suffer. I wish I had gone into some country place in Wales; this is really terrible” (76). And, indeed, Mrs. Hale’s health does begin to decline soon after their arrival in Milton, and it is this illness that forms the subject of the conversation between Dr. Donaldson and local mill owner Mr. Thornton, quoted in the epigraph here, and that preoccupies much of Gaskell’s early narrative.

The conversation between Dr. Donaldson and Mr. Thornton, however, touches on another topic that reaches beyond the individual circumstance of Mrs. Hale’s illness to the wider scope of the industrial working class. In their exchange, Dr. Donaldson notes, somewhat facetiously, that his own trade of medicine increases when Mr. Thornton’s trade of manufacturing declines. Thus environment and health are drawn together as two factors that cannot be untangled, and these links between place and physical and mental wellbeing are reinforced throughout the narrative. North and South reminds us that occupational health matters are not modern concerns only but ones that extend back centuries.

The protagonist of the novel is Margaret, Mr. Hale’s daughter, who struggles to adapt to life in Milton and to overcome her prejudices about manufacturers and industry. As the novel progresses, Margaret begins to learn that a belief about the superiority of the south to the north is a fiction that cannot be maintained, and that there is much to value in her new location. She becomes reconciled to her new home not by accepting its physical environment nor by her gradually developing romance with Mr. Thornton, although these play some part too, but instead by her friendship with local millworkers, a process that begins to open her eyes to matters of social justice, the struggles of the working class, and the ongoing battle between masters and men, which become the main subjects of the novel.

One such millworker, Bessy Higgins, is the first Milton inhabitant Margaret befriends and the first she mourns. Bessy is a young woman whose introduction in the novel focuses on her “unhealthy” appearance (83): physically weaker than her father, often “torn to pieces by coughing” (104), and longing for death to release her from pain. Bad manufacturing times, Dr. Donaldson says, may be accompanied by “undermining of health, and preparation for death” (256-7); but, equally, good manufacturing times can also cause illness and death for workers because of unsafe working conditions. So it is with Bessy, who explains that her illness began with a change of environment: “I began to work in a carding-room soon after, and the fluff got into my lungs, and poisoned me [. . .] Little bits, as fly off fro’ the cotton, when they’re carding it, and fill the air till it looks all fine white dust. They say it winds round the lungs, and tightens them up. Anyhow, there’s many a one as works in a carding-room, that falls into a waste, coughing and spitting blood, because they’re just poisoned by the fluff” (120-1). Such problems can be partly mitigated by the addition of a wheel in the room to “make a draught, and carry off th’ dust” (121), but mill owners are reluctant to install them because they are so expensive. Bessy’s mill had no such wheel and she too has become “poisoned” by the cotton fibers (121). On several occasions Margaret visits the dying Bessy, who is particularly interested in hearing about the beauties of the south as a panacea to her pain: “I like to hear speak of the country, and trees, and such like things” (118).

Bessy is but one face in a panorama of human suffering in North and South. The whole of the millworker class of Milton is Bessy writ large: suffering and dying because of sickness, poverty, and desperation. Yet Gaskell does not offer a maudlin picture of an oppressed working class suffering at the hands of brutal and uncaring mill owners; she also explores the manufacturers’ side, their hardships and challenges, and their failures in maintaining a business in difficult times. Early in the novel, Bessy’s father Mr. Higgins tells Margaret that their friendship has meant that “North and South has both met and made kind o’ friends in this big smoky place” (84), and yet the greater contrast is perhaps not between north and south but between master and man, between mill owner and employee. Gaskell brings together the characters of Mr. Thornton and Mr. Higgins to show the difficulties of forging good relations between employer and employee in a hostile, stressful environment of unionism, violent strikes, failing trade, decreased demand for goods, poverty, and bitterness on both sides. The outcomes of their interactions are small but positive, suggesting ways forward that may contribute not only to increased employee morale but also to physical and mental wellbeing, such as when Mr. Thornton builds a dining room in partnership with the workers so the employees have better food than they have in their homes, and also exemplified in Mr. Thornton’s stated desire towards the conclusion of North and South that future relations between the mill owners and their employees will become “closer and more genial” and that further strikes would be fair and rational rather than “the bitter, venomous sources of hatred” of old (525). Such changes are small, but Gaskell’s novel suggests that it is possible for employers and employees to find common ground and to transcend the difficulties of their working environment in ways that benefit the wellbeing of both parties.



  1. Gaskell, Elizabeth, North and South (London: Penguin, 2012).



ROSLYN WEAVER, BA, has a PhD in literature from the University of Wollongong, Australia, and she completed a postdoctoral fellowship in health and the media at the University of Western Sydney. Her research interests include literature, popular culture, medical humanities, and the media, and she has published across these areas.


Highlighted in Frontispiece Spring 2016 – Volume 8, Issue 2
Spring 2016  |  Sections  |  Books & Reviews

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.