Busman's Stomach 1937
Digestive Disorders and the Making of Modern Politics
by Rhodri Hayward
On 12 May 1937 a motley collection of amateur anthropologists from the newly formed British survey organization Mass-Observation, spread out across London in attempt to uncover the collective fantasies associated with the Coronation of George VI. Mass-Observation was a curious organization. Pitched halfway between a prototypical opinion polling company and a surrealist experiment, its members sought to discover the secret organizing principles that lay behind the accumulated details of everyday life. On 12 May, observers recorded, among other phenomena, the spontaneous celebrations of crowds, the peculiar shapes of commemoratives pies and attempted seductions of soldiers but as one commentator noted, it was a curious fact that no-one mentioned the bus strike.1 The oversight was disappointing. In many ways, the absence of omnibuses on the London streets was the kind of pregnant incident that Mass-Observation had been searching for. It marked a fundamental moment in the history of emotions and the emergence of English modernity. It was moment in which inner feelings – particularly anxiety and depression – emerged as the benchmarks of political programmes and industrial negotiation. The Coronation Bus Strike of 1937 heralded the emergence of a new kind of politics. Although there was, of course, a long tradition of appealing to inner states such as hope or grievance when voicing political demands, the arguments that emerged around the bus strike marked a new departure. The inner feelings that provided the basis for political action were not simply articulated in demagogic speeches or radical pamphlets, instead they were made visible though a marriage of novel statistical techniques and psychosomatic medicine. In the Coronation Bus strike, epidemiology became the medium of political contestation.
The bus strike had been brought about through the concerted action of one of Britain's last great syndicalist worker's movements, the Busman's Rank and File, acting under the aegis of the Transport and General Worker's Union (TGWU). The busmen were campaigning for the institution of a seven hour day, claiming that the intensity of their work was leading to a breakdown in their general health. It was a claim based upon two separate arguments. On the one hand, the busmen could point to the mass of paperwork – timetables, route maps, traffic reports and work rosters – which made visible the intensification of labour; on the other hand, they could point to an apparent change in their inner lives. New levels of stress and anxiety had led, they argued, to the emergence of a new kind of digestive disorder – "busman's stomach" – which could be quantified in the company's sickness records and medical insurance claims. This disorder, conjured out of the mixture of psychosomatic theories, new patterns of somatization and the paper culture of insurance administration would become the central object of the 1937 dispute.
As an illness, busman stomach was a short-lived phenomenon. The first colloquial reference to the condition turn up in hospital records and employee reports in the early 1930s and by the 1960s it had largely disappeared from both popular and medical literature. It was arguably a disease of its time. Busmen interviewed for Llewellyn Smith's New Survey of London attributed the illness to hurried and irregular picnic lunch, the sedentary work of driving, carbon monoxide fumes and the relentless pressure of the job.2 This commonplace connection of the busman's plight to the problems of modernity drew upon a long-standing argument in British medicine that linked emotional strain to alimentary health. Certainly in the writings of eighteenth and early nineteenth-century physicians, including George Cheyne and James Johnson, morbid digestion was associated with national epidemics of hypochondria and by the early twentieth century gastric disorder was frequently coupled with nervous debility and neurasthenia. Yet although the association was long standing, the basis of this connection was understood in very different ways. In nineteenth-century writings it was morbid digestion that disrupted mind and character. The stomach developed tics and idiosyncrasies in response to bad meals and overeating, which in turn lowered the individual's mood or robbed them of nervous energy. In the twentieth century however, this understanding of the relationship between mind and stomach was reversed. Digestive disturbances were no longer seen as the cause of psychological complaints, instead they were understood as their outcome. Stress undermined digestion.
The transformation of the stomach into a barometer of nervous strain rested upon a complex set of manoeuvres. First, there were a series of practical interventions which allowed the form and content of the stomach to be measured in different situations. From the end of the nineteenth century, a whole series of technologies had emerged – the gastrograph, Ryle's "gastro-investigative tube", the x ray and the fractional test meal – that together combined to reveal the occult workings of the stomach and render them quantifiable. These new technologies did not demonstrate a straightforward correspondence between the actions of the stomach and the process of digestion. Experiments on patients with open fistulas and upon laboratory animals such as Pavlov's "pouch dogs" demonstrated that the production of pepsin and gastric acid did not simply correlate with episodes of feeding and digestion. Although in most cases, the promise of food and its associated visual and olfactory cues would trigger a sequence in which peristalsis was initiated and digestive enzymes produced; in anxious or frightened animals this process was disrupted. As the Harvard physiologist, Walter Cannon, noted, the production of gastric juice did not occur when frightened laboratory cats were offered food, but quickly returned on stroking. The disparity between the stomach's actions and the animal's situation was explained by introducing another order of time. The stomach was not simply responding to the external cues of offered food or threatened starvation; rather it was rehearsing primitive responses to perceived threats. As Walter Alvarez, the author of the classic work, Nervous Indigestion (1930) noted, "these nervous inhibitions, of little use to us today, are survivals from our cave dwelling forebears whose lives at any moment might depend on the strength that could be withdrawn from the inner organs and concentrated in muscles needed for fighting or running away."3
The stomach in combination with medical technologies thus enfolded different orders of time. It brought together the lived time of modernity and the ancestral time of evolution and in doing so it opened up the possibility of a new form of critique. In 1933, union organizers began to campaign for a state investigation into rates of digestive disorders in busmen. Following a series of agreements with employers in which workers had agreed to drive at increased speeds (around 10,5 mph on average) busmen had claimed that they were now living under unbearable strain. A year later, the Medical Research Council (MRC) agreed to organize an inquiry. Although the nation's leading epidemiologists doubted that a metric of strain could ever be constructed, Austin Bradford Hill, Reader at the London School of Tropical Hygiene and Medicine, was appointed to undertake an investigation.
Hill set out with modest aims. Noting that reported rates of sickness were influenced by a whole host of factors – from the general age of the workforce through to the rates of sickness benefit payable –, he set out to simply compare the rates of gastritis in bus workers with that of tram drivers, since both groups shared a common age profile, employers and insurance scheme. They presented a kind of natural experiment with their division of labour helping to force workers into groups that could be used for comparative analysis. His choice was backed by TGWU representatives who claimed that it was common knowledge that tramway men were somehow protected from the problems that confronted the busmen.
Hill’s preliminary figures, leaked out from meetings between the MRC and the representatives of the TGWU suggested that there was a slightly higher incidence of gastric disorders in middle aged bus drivers. There were, he noted, 16,3 per cent of all lost days of sickness being attributed to gastric causes in bus drivers between 40 and 49 as against 13,5 in their tramway colleagues in the same age group. Although the proportional difference was small and Hill avoided aetiological speculations, the sheer fact that he had begun to abstract cases of gastritis from the sickness records, and collapse them into a single category for comparison worked to reify busman's stomach as a category, It turned the gastric pains and disturbances which had featured as symptoms in many different illnesses ranging from peptic ulcer to influenza and turned them into a single illness associated with the single occupation. The very act of investigating busman’s stomach granted it a certain objectivity and consistency as incidence was measured between different age groups and across occupations. Statistics worked to magic a new object into existence.
Although Bradford Hill had maintained a scrupulously agnostic position on the aetiology of the putative disorder, the unions and in particular the Rank and File Movement worked hard to connect the illness to the conditions of modern labour. On 2 December 1936, John Langdon Davies, the science correspondent of the News Chronicle, published a scoop on the "strange illness of London bus conductors" urging the public to have more sympathy with bad tempered ticket collectors since the strain of irregular meals and toilet breaks created a situation "in which no human nerves can be expected to control either the gastric juices or the temper".4 A month later, the Sunday paper, Reynolds News,warned women readers not to be seduced by the glamour of the young busman's wit and uniform. Drivers' wives, such as Mrs Dust and Mrs Cravitz of Walthamstow, the paper noted, had seen their husbands wrecked by buswork.5
Three months after Hill's report was leaked, questions were asked in parliament and his epidemiological analysis would find itself reworked into syndicalist pamphlets and folk protest songs. In April 1937, the Rank and File Movement published London Busmen demand the right to live a little longer. They drew upon military health classifications from the Great War, complaining that that the tremendous strain imposed upon the health and nervous systems of the busmen is turning A1 men into C3 scraps. Drawing upon Hill's figures and the records held by the London Omnibus Company (LGOC) Employees Friendly Society they argued that only 10 per cent of busmen reached retirement (343 out of 3,785), with one third being discharged due to ill health at an average age of 46 and 20 per cent (877) dying in service. Radically marrying morbidity statistics and folk music, the busmen composed a lament based upon Hill’s figures to the tune of Clementine:
London busmen stick together
This is your right to see it through
For though buswork may be thrilling
We can prove it's killing too
Only four men in a hundred
Reach the age of sixty five
What’s the use of having a pension
Unless you're still alive
A month later, 27,000 London bus drivers and conductors walked out on strike. On 3 May 1937 the government ordered the establishment of an Industrial Court of Inquiry in which the claims of the competing sides could be heard out. Psychologists and epidemiologists, including Millais Culpin and Bradford Hill, were called as expert witnesses. The turn to scientific evidence however did not bring about any kind of resolution. Instead there was a repeated delegation of the issue to more detailed inquiries, inquiries which only ended with the onset of the Second World War. Yet although the inquiries did not offer any kind of resolution, they did show how the understanding of emotion and the practice of politics had been transformed. As the Marxist biologist, J. B. S. Haldane noted in Communist Party newspaper the Daily Worker in 1939: "The commonest cause of gastritis – that is to say an inflamed and irritable stomach – is worry and anxiety. It is particularly common among busmen and travelling salesmen. I had it for fifteen years until I read Lenin and other writers, who showed me what was wrong with our society and how to cure it. Since then I have needed no magnesia."6 Emotion, as busman's stomach made clear, was not an individual problem. It was rooted in the problems of social organization and the possibility of social justice.
Marx and Engels in The Communist Manifesto famously claimed under the conditions of modernity: "All fixed, fast-frozen relations, with their train of ancient and venerable prejudices and opinions, are swept away, all new-formed ones become antiquated before they can ossify. All that is solid melts into air, all that is holy is profaned, and man is at last compelled to face with sober senses his real conditions of life, and his relations with his kind."7 Yet the busman's struggle showed how this was not a straightforward process. Through the combination of psychosomatic theory, insurance records and statistical techniques, that which was fleeting – moments of inner anxiety or strain – were transformed into enduring objects which could serve in turn as the foundation stones for a better or fairer world.