Fluff on the Lungs: The Real History Behind Millie’s Story

Jenni Ward : 24th February 2025

When writing A Lady Most Intrigued, one of the supporting characters — Millie, the sister of my hero’s closest friend — quietly stole my attention. She doesn’t have long to live; she knows it, and so does everyone around her. Her illness, called “fluff on the lungs” by those in her mill town, mirrors the experiences of thousands of real people in Regency and early Victorian England.

I first came across the term fluff on the lungs while reading Elizabeth Gaskell’s North and South. It’s a heartbreaking story, and Gaskell never shied away from showing the human cost of industrial life. That book — and the beautifully done BBC adaptation — first introduced me to the disease properly known as byssinosis.

What Was “Fluff on the Lungs”?

Byssinosis, often called “brown-lung disease,” affected textile workers who spent their days surrounded by floating cotton dust. The fine fibres irritated and inflamed the lungs, making it harder and harder to breathe. In reality, it wasn’t just dust; the cotton carried bacterial endotoxins that triggered chronic inflammation and irreversible scarring.

For mill workers, symptoms began as coughing fits and tightness in the chest, often worse on Mondays after a weekend away from the factory. Over time, the attacks became constant, the lungs weakened, and many — especially young women like Millie — died far too early. There were no protections, no understanding of industrial hazards, and very little compassion for those considered replaceable labour.

The interior of an old cotton mill with light coming through the large windows into the room

Visual representation of Millie from A Lady Most Intrigued by Jenni Ward. Shows a young woman with brown hair wearing working clothes and a brown shawl.

Why I Wanted to Include It

Millie’s illness isn’t there for shock or sympathy; it’s a reflection of the quiet tragedies that shaped working-class life in that era. While most Regency stories focus on glittering balls and drawing rooms, I wanted to show what life looked like outside those walls — where survival was a daily effort, and illness was part of the landscape.

Including Millie’s story gave me a way to explore not just death, but dignity — how families continued to care, laugh, and love even in the shadow of something they couldn’t change.

A Personal Connection

This part of history isn’t abstract for me. My father’s family came from Rawtenstall, Lancashire, a cotton-mill town through and through. Census records show several generations of my ancestors working in those mills right up until the twentieth century. My great-grandfather began as a mill boy before becoming a watchmaker and later emigrating to Australia.

When I was researching Millie’s condition, I couldn’t help wondering what those earlier generations had seen, heard, or breathed in. It makes the story feel both closer and heavier — a reminder of how easily history folds into family memory.

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