This new monograph brings to life the dangers that workers faced in the mining, manufacturing, and railway industries, and traces labor, industry, and state responses to industrial injuries in the nineteenth century from a transatlantic perspective. Britain and America shared a similar system of common law that was singularly hostile to the laboring classes. The workforce were generally allocated blame for industrial accidents and consequently bore the brunt of the immediate and long-term social consequences of bodily damage sustained in the workplace.

The narrative opens with a description of the nonfatal but dramatic injuries sustained by railway laborer Phineas Gage. Gage accidentally sparked a quantity of black powder, which blasted the iron tool he was using directly into his brain from beneath his eye and out through the top of his skull. As Jamie Bronstein quite rightly points out, this story is more familiar to students of psychology. The destruction of Gage's frontal lobe allegedly facilitated greater understanding of the localized nature of brain functioning and inspired surgical lobotomies. Nonetheless, the aftermath of Gage's injuries highlights a common plight of many nineteenth-century workers injured during the course of their employment. Gage initially received medical care subsidized by his employers but was left disabled and unable to fully support himself. This resulted in him living an itinerant, hand-to-mouth existence for the remainder of his life (1–2). Five themed chapters follow this account. They explore work-related hazards, the options open to workers in the event of injury, the cultural meanings of accidents, the “paradox of free labour,” and the responses of the state.

Traditional interest in the “founding fathers” of industrial medicine has recently been replaced by occupational health histories of labor and research exploring the emergence of protective legislation, particularly in the mining, asbestos, and rail industries. Although Bronstein makes no reference to these studies, she clearly engages with current themes in the historiography. These have included the significance of organized labor's role in reform, benign versus negligent responses to industrial injuries by the state, women as gendered subjects in the workplace, the limits of contemporary knowledge in the understanding of occupational hazards, and agency versus victimization. Yet the study lacks a definitive view of where Bronstein actually stands within these contested areas. For example, she clearly attributes to labor a positive role in the introduction of compensation initiatives in 1880, but was this at the expense of safety concessions, as some British historians have argued? The strength of her study lies in the exploration of both the cultural and social meaning of accidents, which charts new territory, and the “paradox of free labour.”

Bronstein challenges the assumption that worker apathy was behind the failure of the British government to act decisively on compensation issues before 1880 (the idea of no-fault compensation had been mooted since the 1830s). She uses a wide range of largely untapped source material, such as religious tracts, autobiographies, poetry, songs, and broadsheets to reveal how the workforce called for systematic changes to the system but were hindered in their pursuit of reform by a culture of “masculine stoicism,” fatalism, and also the perception of the injured worker as “male and a free agent” (96).

The inclusion of an American comparison, which highlights questions of race and slavery, ensures that the theme of free agency will be of particular interest to British historians researching in the field of protective labor legislation. Like the situation of women and children, who were buffered from the “worse excesses of industrialization by the notion that their irrationality made them incompetent judges” of workplace hazards, the condition of servitude operated similarly (97). Hirers of slaves were responsible both for providing medical care and for paying owners compensation in the event of bodily damage (105). Bronstein suggests that for free white male workers in Britain and America, compensation for injury was largely equated with being “a dependent noncitizen” (123). This resulted in hard choices. To join forces with dependent labor compromised their masculinity. On the other hand, to rely on self-help strategies with other free workers could result in a missed opportunity “to deploy the occasional paternalism of parliament” (125). It was not until the Reform Act of 1867 widened the franchise in Britain and strong union representatives, such as Burt and Macdonald, entered Parliament that protective labor legislation was presented to the workforce as “essentially just and necessary” rather than “unmanly.” As a consequence, demand for reform emerged in strength (126).

The subsequent enactment of employers’ liability law in 1880 eventually introduced a system of no-fault compensation. In America, however, Bronstein suggests, a closer association between technology and progress, republicanism, and stronger notions of free labor, together with decentralization, hindered consideration of a similar scheme for some twenty years after the British initiative (169–70). Bronstein ends her story with a short epilogue that contains a powerful note of caution. A predictable regime of compensation may have relieved the workforce of insufferable burdens, but, in turn, it both obliterated awareness of the harsh impact that labor still has on the human body and obscured the issue of fault, leaving industry “free to take calculated risks with workers' lives” (175).

This is a study in medical history that is engaging, with broad appeal. It will be of interest to scholars in a wide variety of disciplines at undergraduate and postgraduate levels on both sides of the Atlantic.