This book was originally published in 1832. Dr. James Philips Kay (later Sir James Kay Shuttleworth) studied medicine in Edinburgh and then began to practise in Manchester where he acquired a wide knowledge of working-class conditions and diseases. In 1831-2 he acted as secretary to the Manchester Board of Health which was set up to combat the threatened cholera epidemic, and it is thanks in part to the devoted labours of Kay and his colleagues that the epidemic in Manchester was less severe than in other cities.

This vividly written pamphlet embodies the fruits of Kay Shuttleworth's experiences in the capital of the cotton kingdom. He describes the newly set up Boards of Health investigatings into the state of Manchester's poor, and enumerates the causes of their physical depression, with all its attendant moral degradation and predisposition to disease. As well as supplying statistics for pauperism, crime and mortality, Shuttleworth provides suggestions for improving working class conditions.

This is the best known of all the literature produced about workers' ocnditions in the early nineteenth century, and is a work which has been widely quoted and used by both economic and social historians.