Invalidism and Identity in Nineteenth-Century Britain 9780226261225

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Invalidism and Identity in Nineteenth-Century Britain

INVALIDISM AND IDENTITY in Nineteenth-Century Britain

Maria H. Frawley

THE UNIVERSITY OF CHICAGO PRESS CHICAGO AND LONDON

Maria Frawley is associate professor of English at George Washington University. She is the author of A Wider Range: Travel Writing by Women in Victorian England (1994) and of Anne Bronte (1996), and she has recently prepared an edition of Harriet Martineau’s Life in the Sickroom (2003). The University of Chicago Press, Chicago 60637 The University of Chicago Press, Ltd., London © 2004 by The University of Chicago All rights reserved. Published 2004 Printed in the United States of America 13 12 11 10 09 08 07 06 05 04 ISBN: 0-226-26120-4 (cloth)

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Library of Congress Cataloging-in-Publication Data Frawley, Maria H., 1961– Invalidism and identity in nineteenth-century Britain / Maria H. Frawley. p. cm. Includes bibliographical references and index. ISBN 0-226-26120-4 (cloth : alk. paper) 1. Chronic diseases—Great Britain—History—19th century. I. Title RA644.8.G7F73 2004 306.4613—dc22 2003022007  The paper used in this publication meets the minimum requirements of the American  National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, ANSI Z39.48-1992.

CONTENTS

Acknowledgments vii Introduction 1 1

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“ALL MY AFFLICTIONS” Invalids and Authority in Nineteenth-Century Britain

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“BEYOND HOPE, HELP, OR REMEDY” Confession, Cure, and the Hypochondriac’s Narrative

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“IN SEARCH OF HEALTH” Invalids Abroad

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“SIN-SICK SOULS” Christian Invalids and the Literature of Consolation

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“THE RANGE OF OUR VISION” Self, Surveillance, and Life in the Sickroom

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AF TERWORD

Centers, Margins, and Vanishing Points: Locating Invalidism in the Nineteenth Century 245 Works Cited Index 279

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ACKNOWLEDGMENTS

I owe my first debt of gratitude to the Burroughs Wellcome Fund, which made possible two research trips in 1996 that let me access the extraordinary collections of materials at the Wellcome Institute for the History of Medicine and at the British Library. A fellowship supported by the National Endowment for the Humanities enabled me to take a full year sabbatical to begin working with the materials I gathered abroad and to draft this book; to the NEH I am grateful not only for this tangible support, but also for the validation and encouragement given by their panel of readers. One of the true joys of writing a book is the opportunity to work closely with librarians. I owe special thanks to staff members at the Wellcome Library, the British Library, the Bodleian Library, and the National Library of Medicine. Many librarians and archivists have helped me gather illustrations for this book: thanks in particular go to Martin Durrant at the V&A Picture Library, Sandra Powlette at the British Library, and Matilde Nardelli at the Wellcome Trust Medical Photographic Library. It is impossible to give appropriate tribute to the help I have gotten from friends and colleagues in the world of Victorian studies: informal conversations about invalidism with Patrick Leary, Ellen Rosenman, Anka Ryall, Leslie Hall, Martha Stoddard Holmes, Ann Colley, Crystal Downing, Andrea Broomfield, Sally Mitchell, and listmembers of victoria have been invaluable. So too has been the response to papers I have presented before the members of the Research Society for Victorian Periodicals, the Victorians Institute, the Interdisciplinary Nineteenth-Century Studies Association, and the Northeast Victorian Studies Association. I truly appreciate the insights and support I have obtained from my wonderful graduate students and colleagues at the University of Delaware, especially Jerry Beasley,

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Acknowledgments

Barbara Gates, Charlie Robinson, Martin Brueckner, Jonathan Grossman, Kathryn Miele, Meredith Wunderlich, and Cheryl Wilson. In their unwavering support of each other, my parents, Barton and Sabrena Hinkle, have provided an inspirational model of living with chronic illness. For their many expressions of pride in my work, I am grateful. My heartfelt thanks go also to my children, Christopher and Emma Frawley, for their spirited ability to put all things in perspective. Most of all, I thank Bill Frawley, both for the calm help he never fails to provide and, more important, for his love and encouragement.

INTRODUCTION

For it is not altogether ill with the invalid, after all. —Robert Louis Stevenson, “Ordered South”

Responding to an admirer who had written to ask after her health, Florence Nightingale once wrote, “I am an incurable invalid, entirely a prisoner of my bed (except during a periodical migration) and overwhelmed with business.” 1 Nightingale so designated herself an “invalid” at the height of her extraordinary career, evidently seeing no conflict between her posture of incapacity, her understanding of herself as “incurable,” and her intense commitment to and engagement with work. This book queries the complex set of assumptions underlying Nightingale’s statement and many others like it. It investigates the capacity of the nineteenth-century invalid to embody productivity and at the same time be emblematic of fatigue and waste. It considers the conditions under which confinement could be experienced as liberating. And it asks, If incurable but still at work, relegated to bed but still capable of travel, was the invalid something of an impostor? In Invalidism and Identity in Nineteenth-Century Britain, I attempt to uncover and assess the peculiar and distinctive features of nineteenth-century culture that made it not only possible but relatively common for people to identify themselves or others as invalids. And I try to ascertain just what that designation meant to a rapidly industrializing nation. Florence Nightingale may have been one of her period’s most prominent invalids, but she was not its only one. Hundreds of men and women either were invalids or

1. An excerpted portion of this letter, dated 2 October 1866, appears in Veith 83.

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Introduction

believed they were, and they wrote works premised on that identity. Their narratives are my subject. In 1996 a grant from the Burroughs Wellcome Fund enabled me to begin work on this book at the Wellcome Institute for the History of Medicine and at the British Library. While I embarked on the project with an extensive bibliography of essays people had written about their experiences with chronic or extended illness, in London I discovered a rich repository of additional primary sources: advice books, hymnals, prayer books, inspirational works, confessional literature, travel accounts, tracts, and essays, all written by invalids and in many cases directed to an audience of the ill. Sharing experiences and offering advice, the invalids who wrote these texts helped to generate a market for a distinctive yet varied form of literature; they produced hybrid narratives that combine features of the autobiographical with other genres of writing, and they imbued their works with the overtone of self-help. Invalidism and Identity retrieves the figure of the invalid and the invalid’s narrative from the margins of literary, medical, and social history. Medical historians routinely lament their profession’s overemphasis on the institutional. In “The Patient’s View: Doing Medical History from Below,” Roy Porter long ago urged historians to consider how focusing on the patient’s point of view might alter medical history.2 His call has been echoed by others. In the introduction to Framing Disease, for example, Charles Rosenberg observes, “We need to know more about the individual experience of disease in time and place, the influence of culture on definitions of disease and of disease on the creation of culture, and the role of the state in defining and responding to disease” (xxiii). Arguing that physician-centered approaches constitute a “major historical distortion,” Roy Porter in particular advocated the development of a “historical atlas of sickness experience and response,” one “graduated by age, gender, class, religious faith, and other significant variables” (“Patient’s View” 175, 181). Unique in its capacity to denote at once experience of sickness and response to it, invalidism in its nineteenthcentury manifestations simultaneously shaped and was shaped by just such determinants of (or influences on) identity as those delineated here. In its focus on the “ontologically shifty” figure of the invalid (Heller 95)—perhaps once, but not necessarily still, categorized as a “patient”—this book pro2. As early as 1945, the physician Douglas Guthrie published “The Patient: A Neglected Factor in the History of Medicine” in Proceedings of the Royal Society of Medicine. His discussion is limited, however, to the patients of famous physicians and to celebrated patients such as Typhoid Mary. Guthrie asserts—wrongly, I argue —that “the contribution of the patient is passive, and few patients, even if they happen to be also medical men, are concerned with the benefit to humanity which may accrue from their sufferings” (490).

Introduction

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vides distinct contours to the medical topography, the “sufferers’ history,” that Roy Porter once envisioned.3 I am certainly not the first to embark on mapping nineteenth-century British medical history “from below.” 4 In the nearly two decades that have elapsed since Porter wrote “The Patient’s View,” numerous scholars have moved well beyond the paradigms of institutional and professional history and celebratory physician biography, sometimes through a focus on the medical experiences and conditions afflicting particular individuals (Charles Darwin, Elizabeth Barrett Browning, and Florence Nightingale are noteworthy examples) and sometimes through attention to particular categories of disease (e.g., gout, nervous disorder, hysteria, and tuberculosis). Taken in conjunction with more generalized studies of the culture of sickness and health in nineteenth-century England such as Bruce Haley’s The Healthy Body and Victorian Culture, Peter Logan’s Nerves and Narratives: A Cultural History of Hysteria in Nineteenth-Century British Prose, and Athena Vrettos’s Somatic Fictions: Imagining Illness in Victorian Culture, as well as with work on the significance of Victorian fictional representations of illness such as Lawrence Rothfield’s Vital Signs: Medical Realism in Nineteenth-Century Fiction and Miriam Bailin’s The Sickroom in Victorian Fiction: The Art of Being Ill, this scholarship has provided a wealth of information through which to understand invalidism as a dominant, if imprecisely defined, feature of nineteenthcentury England’s medical culture. Signifying not simply a medical condition or exclusively a social role, invalidism might more profitably be thought of as cultural mentality, a mode of thought that shaped and a posture that expressed the way men and women conceptualized, experienced, and represented a wide range of afflictions.5

3. Tamar Heller’s description of the invalid as “ontologically shifty” is made in the context of a more general discussion about feminist interest in the medical gaze and in figures that transgress boundaries and defy easy classification. 4. By positioning my study this way, I align my subjects with the hierarchy that Roy Porter referred to in “The Patient’s View,” in which the patient is construed as occupying a position lower than that of the medical establishment. In “Interfaces: Perceptions of Health and Illness in Early Modern England,” Andrew Wear offers an important revision of this paradigm by describing his own work, which, like mine, uses “diaries, letters, autobiographies, travellers’ accounts, doctors’ case books, religious tracts, cookery and medicine books, etc.,” as “history from the middle,” by which he means the history of “literate but often unimportant people” (231). Chapter 1 of my book discusses at length the association of invalidism with people of the middle classes, and by describing my project as a kind of “history from below,” I do not want to obscure this important association. 5. In “The Social Construction of Medical Knowledge,” Ludmilla Jordanova advocates using these terms as a way to avoid reifying the knowledge claims of medicine, arguing that because “all are socially fashioned,” we should not distinguish the “claims of medicine from its practices, institutions, and so on” (362).

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Introduction

If Invalidism and Identity contributes to an emerging model of medical history, one that foregrounds the experiences of those who thought of themselves as invalids and who wrote about it, it is nevertheless important to recognize up front a range of issues that mandate special caution about the conclusions we can legitimately draw from documents written by (and for) invalids. The wide-ranging primary sources I enumerate above and draw on throughout this book provide much material for what might be deemed a “history by inference” (Porter, “Patient’s View” 183). But numerous factors occlude and complicate what otherwise might be a relatively straightforward process of deduction. Many invalids, for example, opt not to provide specifics about their medical histories, the conditions presumably contributing to, if not entirely accounting for, their status as invalids. Wilkie Collins’s essay “Laid Up in Lodgings” is representative of many other narratives in this respect: “Neither is it at all worth while to occupy time and space with any particular description of the illness from which I have been and am still suffering,” he writes by way of introduction (199). The absence of specific medical information in most invalids’ narratives necessarily—and perhaps fortunately—undercuts any effort to reconstruct their experiences through a medical model of symptom, diagnosis, treatment, and response. In certain respects their narratives prove equally resistant to standard literary readings of suffering. Counseling their “fellow sufferers” on how to endure illness, invalid narrators often undercut their readers’ anticipation of recovery and resolution and, in doing so, challenge the argument of some literary critics that sickness provided Victorian writers with a narrative means to enact crisis and to imaginatively represent resolution of personal and social conflicts. Perhaps most significantly, many of the narratives considered here were published anonymously; they were marketed as having been written “by an invalid” and sometimes were specifically directed to an audience of “fellow sufferers.” In various ways these features make it more challenging to come to terms with the authorship and authority of invalid narratives, and they underscore an essential fact about the anonymous and yet categorically recognizable identity of their authors: the invalid was not only an especially ambiguous type of medical figure but also a multivalent social actor, one who played a “sick role” scripted in various ways by society and inflected by other dimensions of identity, chief among them gender, class, nationality, and religious belief. However scripted the sick role, many nineteenth-century invalids brought to their performances their own distinctive voices, and these voices influence their narratives in fascinating ways. In my selection of materials and discussion of particular works, I try to capture this individuality

Introduction

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even as I assess how representative individual narratives are of broader cultural trends. Thus the chapters that follow quote liberally and often from invalids, truly the “choir invisible” of nineteenth-century Britain. My motivation is not simply to provide space for a voice until now little recognized in medical and cultural histories of the period, but to uncover specific features of invalid writing that can help us understand what the identity presupposed, what sorts of rhetorical strategies and cultural codes were embedded within the authors’ discourse, and what we can deduce about the invalid authors’ readership, whether real or constructed. Invalid authors’ repeated recourse to a language of pleasure and pain, capacity and incapacity, reveals much about the basic perceptions of selfhood, agency, and performance that underwrote their identification as invalids. Chapter 1 of Invalidism and Identity situates these issues within an overview of the social and historical forces that helped to shape the invalid’s cultural prominence. Evangelicalism, for example, ratified affliction as Godgiven and enabled sufferers to believe that their chronic illness would promote spiritual transformation. Industrialization produced categories of work that helped to generate new beliefs about physical and mental performance, capacity, and exertion. These in turn resulted in new medical categories, many of them associated with the concept of “overwork” and nearly all of them coded with additional assumptions about gender and class differences. The emergence of scientific medicine brought with it both new diagnostic tools and new assumptions about the necessity of case taking that inevitably changed the nature of the doctor-patient relationship. In short, the experience of sickness changed over the course of the century; as it did, so too did the significance of being labeled incurable. Although not all invalids believed themselves incurable —or were believed to be —they occupied a liminal position vis-à-vis the medical profession and the social world. Indelibly considered long-suffering, the invalid almost by definition signified medicine’s inability to ensure recovery. To have become an invalid was to have moved out of medicine’s narrative of promise, a trajectory marked by diagnosis, treatment, and cure. One became ensconced within a more stationary, nonlinear space, inhabiting a secluded sickroom and embodying stasis in a culture celebrating mobility and obsessed with flux. A central argument of this book is that as an apotheosis of inertia, the invalid tapped into and expressed deep-seated societal doubts— doubts not only about medicine’s potential to cure, but more fundamentally about progress and mobility, both master narratives of nineteenth-century culture. While poststructuralism has taught contemporary critics to see the

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Introduction

body as a site where social and political conflicts are inscribed, contested, and resolved, I argue that nineteenth-century culture attributed to the invalid’s body an opposite but equally crucial power—the ability to unsettle, the capacity to be indeterminate. Despite the invalid’s manifest recognizability as a type, variations within that type prove crucial to grasping the range of the figure’s cultural presence. The chapters that follow chapter 1 are focused on distinct manifestations of invalid identity and the narrative forms and rhetorical strategies that best suited and served the invalid authors’ needs. It is worth acknowledging at the outset that, like all taxonomies, the one this book establishes is inevitably not comprehensive; if my categories for analysis represent the most pronounced patterns in invalid-written narrative, they should not be seen as wholly encompassing the culture of invalidism or as being rigidly demarcated. My purpose is to help readers appreciate the variety of ways that medical condition and social role come together within narratives of invalidism. To this end, I have organized materials in a way that foregrounds commonalities and patterns in the self-representational techniques and literary modes adopted by various authors who identified themselves as invalids. While in some narratives invalidism is represented as wholly subsuming other components of the author’s identity (such as age, religious belief, or gender), in other cases it is represented as forcing the writer to confront and contend with some other crucial aspect of identity. Structuring this book around the invalid authors’ self-representational techniques and chosen literary modes enables me to highlight such instances and to assess how and why particular narratives become modulated by their authors’ concerns with or beliefs about issues such as gendered identity, nationality, or religiousness. The chapters that follow from chapter 1 represent two major strands of invalid writing: one studies narratives in which the invalid author is invested in restoring health or finding relief from suffering, and the other studies narratives written by those who, whether chronically ill or simply facing a prolonged convalescence, were more interested in representing and analyzing the experience of incapacity. These might be thought of as the two dominant postures available to invalids, and they generated different assumptions about the invalid’s social role as well as the invalid author’s relation to readers. First I examine narratives produced by invalids whose search for restoration or relief involved experimenting with therapeutic treatments offered by the medical community, broadly defined. Chapter 2, “‘Beyond Hope, Help, or Remedy’: Confession, Cure, and the Hypochondriac’s Narrative,” analyzes the particular appeal that the confessional mode

Introduction

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had for invalids suffering from nervous disorders, particularly hypochondria, and the related use of confessional narratives as a way to “come out” as an invalid. Chapter 3, “‘In Search of Health’: Invalids Abroad,” assesses the ways a culture of tourism and the emerging field of medical climatotherapy converged to encourage many invalids to leave home on the proverbial “search for health” and examines the implications of that journey for our understanding of the particular kind of agency the figure of the invalid tourist represented. Although chapters 2 and 3 are focused on different types of invalids and forms of narrative, it is striking that masculinity proves to be the component of identity most crucial to understanding how invalidism was experienced and represented in the texts most central to my analysis. There is no single or simple explanation for why most of the narratives examined in these chapters are written by men. Indeed, one of the challenges of this portion of the book will be to tease out of the material the ways various authors came through their experience with invalidism to grapple with issues of masculine identity. Medical beliefs about the ways “overwork” could result in “shattered nerves” led many middle-class men both to experience debilitating symptoms and to experiment with therapeutic regimens designed to provide relief. Middle-class women were less likely to be associated with the workplace, and though a Victorian woman who exerted herself in intellectual work might have been similarly diagnosed as suffering from “overwork,” treatment in her case would more likely have been simply telling her to stop working, and possibly recommending bed rest. Many of the invalids who traveled abroad sought relief from the symptoms of consumption—a disease as likely to afflict men as women. But men more often sought to publish accounts of their experiences as invalids “in search of health,” in part because domestic ideology tended to validate activity and exertion by men, even invalid men, and in part because the tradition of guidebook writing was more often, though certainly not exclusively, associated with men. These and other issues examined in more detail in chapters 2 and 3 help to account for the focus on texts written by men. Next I turn to the writing of those who, rather than seeking relief from their afflictions, sought to represent and analyze the experience of being confined—either permanently or during convalescence. Given the more passive-seeming posture of this type of invalid, it is no surprise to find here a more representative sampling of narratives by women. While domestic ideology, medical understanding, and the iconography of the period ensured that most middle-class women in the nineteenth century would not have associated being bedridden and confined to home as compromising their

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Introduction

femininity, the men who sought to represent the experience of being “confined” by sickness were very much preoccupied with their masculinity. In a range of ways, the nineteenth-century sickroom itself was gendered as feminine, and men writing about their experiences there reveal fascinating responses to that association. Gender is only one of the lenses we need to look through to appreciate the types of narrative devoted to representing the invalid’s interiority, however. Chapter 4, “‘Sin-Sick Souls’: Christian Invalids and the Literature of Consolation,” focuses in particular on commonplace books written by invalids, many of them published anonymously. Using invalid hymnals, prayer books, and Christian tracts to situate a reading of these commonplace books, this chapter concentrates both on how a religious language of sin and salvation supplants the medical model of disease and healing in the Christian invalid narrative and on that figure’s use of a rhetoric of resignation, which only seems to deprive the sufferer of agency, the capacity to invoke will, exert power, and take action. Chapter 5, “‘The Range of Our Vision’: Self, Surveillance, and Life in the Sickroom,” examines a series of narratives that, while similarly situated in the geographic imaginary of the sickroom, instead foreground the psychological interest of invalidism by representing the invalid’s habits of mind and propensity for self-contemplation. These four main chapters comprehend central strands of the “ecological niche” that invalidism occupied in nineteenth-century culture. In Mad Travelers, Ian Hacking deploys this term to describe a phenomenon “not just social, not just medical, not just coming from the patient, not just from the doctors, but [one that emerges] from the concatenation of an extraordinarily large number of diverse types of elements which for a moment provide a stable home for certain types of manifestation of illness” (13). I argue that throughout the nineteenth century, Britain experienced such just a moment and that invalidism was the most prominent manifestation of that “home” for representations of extended suffering. In their embodiment of stasis, invalids may well have expressed a range of anxieties about progress in nineteenth-century Britain, but their narratives are anything but static. Often shrewd and ironically self-aware, full of lively commentary, invalid authors in numerous ways explore their culture’s most basic assumptions about the meaning of health (and affliction) to social life. They offer multifaceted and multivalent representations of the invalid body as a site where beliefs about productivity and consumption, capacity and incapacity, exertion and fatigue compete for ascendancy. The competition does not by century’s end resolve to produce clear-cut victors, and in keeping with this so-

Introduction

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cial and historical reality, I resist the temptation to offer a tidy summary of invalidism’s rise and fall. As Toby Gefland as written in another context, “Historical problems, problems of societies, do not respect disciplinary boundaries” (18). For this book, it makes as much sense to stress that disciplinary problems do not respect historical boundaries. Although focusing on nineteenth-century British manifestations of invalidism, I necessarily dip into a range of materials from the periods bounding my own. I allow myself the freedom to draw on some texts by American invalids, in part because the periodical press presents such compelling evidence for transatlantic circulation of invalid narratives and also because the American experience of invalidism overlaps with the British experience in crucial ways. Ultimately, I try to offer a story of a culture continually, if unevenly, preoccupied with a figure at once debilitated and yet also undeniably privileged. Confronting through the figure of the invalid the medical and social promise of restoration and normality, nineteenth-century thinking might in fact shed light on our own historical moment, characterized as it is by equally complicated attitudes about health, ability, and disability.

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“ALL MY AFFLICTIONS” Invalids and Authority in Nineteenth-Century Britain

The beginning of Inquiry is Disease: all Science, if we consider well, must have originated in the feeling of something being wrong. —Thomas Carlyle, “Characteristics”

I

n 1852 the publishers Aylott and Jones in London issued a work titled The Invalid’s Own Book, written anonymously by “a Fellow Sufferer.” Invoking a rhetoric of reticence familiar to midVictorian readers, the author uses the preface, dated November 1850, to justify the “little work” by asserting her own beneficent motives and the book’s utilitarian promise. “The compilation of this little work originated in the attempt to cheer and profitably employ some of the solitary hours of one who for many months has been confined to the bed of affliction,” she explains. Later she continues: “In the hopes of presenting, in a small compass, many topics of consolation to some fellow-sufferer, to whom the compiler would not otherwise have access, this little volume is committed to the press. Accompanied by the Divine blessing, she trusts that her labour will not be in vain.” The passage is vintage Victorian in its depiction of a lonely sufferer seeking from her own bed of affliction to console others, envisioned as similarly confined to their sickrooms and in need of solace. Like many men and women of the period, the person who wrote this book assumed that her identity as “invalid” would speak for itself on the book’s title page. Similarly, she assumed a community of sufferers to whom her thoughts could be directed. She was not alone in her efforts, for books, tracts, and essays with titles such as The Solace of an Invalid, An Invalid’s Day, Literary Gleanings by

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“All My Afflictions”

an Invalid, and The Idle Hours of an Invalid appeared throughout the nineteenth century. This book is a study of what it meant to identify oneself as invalid in nineteenth-century Britain and of what the culture of invalidism tells us about a particular moment in literary, medical, and social history. In what ways did the term “invalid” designate a medical condition, and what kinds of medical conditions could fall under that rubric? In what ways did invalidism signify a social role? And did that role confer status or rather marginality and insignificance? While some of the period’s best-known intellectuals, writers, and activists (e.g., Florence Nightingale, Elizabeth Barrett Browning, Charles Darwin, Alfred Lord Tennyson, Thomas Henry Huxley, and Harriet Martineau, to cite just a few) were known to have identified themselves as invalids at key points in their careers, we know little about how the experience of invalidism differed for those leading more ordinary, less celebrated lives. Beliefs about illness and health affected men, women, and children in different ways, as did factors such as class, religious affiliation and belief, and sexual orientation. These and other factors combined to produce important variations throughout the century in how individuals would respond to chronic illness and, as important, how others would respond to them. Yet in a range of ways that this book will explore, the experience of invalidism might be said to have subsumed other determinants of identity. Individuals could declare themselves “invalid” (or be designated by society as “invalid”) and know that that identity would then supersede other dimensions of their personhood. Just as the Victorians cannot be held responsible for inventing invalidism, neither can they be credited with creating the figure of the invalid or its near relations—the cripple, the malingerer, the valetudinarian, the hypochondriac, the malade imaginaire. Nevertheless, in the first half of the nineteenth century the figure of the invalid assumed a kind of public visibility unparalleled in earlier periods of English history. Charting the conditions that promoted this ascendancy, I will argue that the invalid assumed prominence because the figure apotheosized stasis. As Harriet Martineau wrote in Life in the Sick-Room, “It is when death is not to be looked for, nor yet health, that the test is applied” (33). Neither healthy nor critically ill, the invalid instead occupied what Alexander Shand, in an essay titled “The Pleasures of Sickness,” rhapsodically described as a “blessed borderland of convalescence” (546). However “blessed” was the “borderland” that the invalid occupied, extended or chronic illness could also signify stagnation, immobility, and, in a broader sense, all that could be considered inconclusive. In “The Convalescent,” Charles Lamb evocatively likened his condition to a

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“flat swamp” (Essays of Elia 271). Epitomizing inertia, the invalid expressed the culture’s profound skepticism not simply about the inability of scientific medicine to cure, but also about other social movements, institutions, and ideologies premised on the notion of progress—the economic progress of the nation, the spiritual progress of the pilgrim. Although the paradigm of crisis and recovery has long been believed to be constitutive of Victorian literature and a basic premise of realist fiction— “to be ill is to produce narrative,” Athena Vrettos writes in Somatic Fictions (2)—the invalid’s presence in that fiction unsettles the apparent truisms underlying the paradigm. Examining illness as a “rite of passage issuing in personal, moral, or social recuperation,” Miriam Bailin makes an astute observation that complicates the pattern of crisis and recovery: “The conventional pattern of ordeal and recovery takes on its particularly Victorian emphasis in the location of the desired condition of restored order and stability not in regained health but in a sustained condition of disability and quarantine” (Sickroom 6). Signifying not crisis, but rather a state of lingering, stasis, and inertia, invalidism challenged what John Freccero identifies as “the very nature of narration” itself—that is, “the fact that a sentence, a life, or a book must have an ending” (28). Moreover, if convinced of the invalid’s capacity to access spiritual truths unavailable to the healthy, Victorians were equally compelled to regard the figure with doubt, and this ability to simultaneously embody competing claims of truth and fraudulence, and thus to express cultural anxieties about duplicity and the power of the impostor, helped to secure the invalid a powerful narrative and cultural position. Praising Joseph Joubert for his authenticity (“his changeless preference of being to seeming, knowing to showing, studying to publishing”) Matthew Arnold remarks, “for what terrible public performers have some invalids been!” (172). Evidence of the invalid’s omnipresence in nineteenth-century culture is abundant and stems from a wide range of sources. Lithographs, watercolors, engravings, and etchings by artists as varied as George Cruikshank, George Du Maurier, and Francis Engleheart routinely depicted the infirm, afflicted, and bedridden. In its representation of a young invalid woman both marginalized from the scene and arguably central to it, Thomas Webster’s popular painting of 1843, “Sickness and Health,” exemplifies the figure’s ambiguous status within domestic culture (fig. 1). While artistic renderings tend to depict invalids as young and female, other arenas of representation present invalidism, if indirectly, as more universal. Among the many “new inventions” promoted in the pages of the influential medical journal the Lancet and advertised in other forms of print were invalid cups and spoons,

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“All My Afflictions”

Figure 1. “Sickness and Health,” by Thomas Webster, R.A. 1843. Reproduced with permission of the V&A Picture Library.

chairs, beds, and couches—devices akin to the “patent invalid carriage with ‘a thousand springs’” that enabled Elizabeth Barrett Browning to travel (Hewlett 82–83) (figs. 2 and 3). Skimming the London Times for the period, one finds articles promoting special life assurance societies for invalids, articles describing associations and institutions designed to aid invalid children, invalid women, and invalid soldiers and sailors, and announcements of such newly patented items as “invalid bedsteads” and “net hammocks for invalid travelling.” Advertisements in popular magazines and newspapers appealed to invalid consumers with promises of healing balms and extracts, effervescing lozenges, and “universal plaisters” for conditions as varied as cancer, asthma, “white swellings & Hard Lumps,” and “inflammations of every kind.” Noting that “illness and its fragile twin, health, were marketable commodities,” Katherine Ott describes the lucrative market in patent medicines, atomizers, and chest expanders that tuberculosis in particular made possible. “Like so many Ezekiels calling dry bones to life, consumptives bought scales, thermometers, sputum cups, paper handkerchiefs, rubber pocket liners, tents, recliner chairs, invalid beds, awnings, and disinfectants,” she writes (88). Support groups and aid associations for invalids sprang up, and “invalid asylums” courted the families of the afflicted with

Figure 2. “Invalid Chairs.” Courtesy, National Library of Medicine.

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Figure 3. “Hooper’s Invalid Bed-Lift and Elastic Water Mattress.” 1889. Courtesy, National Library of Medicine.

brochures detailing the comfort, care, and security that awaited the invalid relative too difficult to care for at home. Prayer books and hymnals written for (and occasionally by) sufferers appeared alongside more secular tracts of consolation and self-help. Cookbooks and household manuals devoted to the special dietary needs of the invalid or dyspeptic proliferated. Travel books and medical guides to health resorts from the period abound in images of the English invalid abroad. Studying southern and Swiss health resorts in 1883, the physician William Marcet observed “young people with a family disposition to consumption; ladies fatigued by the London Season; persons suffering from chronic rheumatism whose pains and stiffness of limbs are invariably increased by cold; elderly people with bladder infections; other invalids undergoing general wasting and gradually losing strength from disease of the kidneys; people with weak hearts, who are utterly incapable of exerting themselves in cold weather; scrofulous children; and persons recovering from some long debilitating illness” (313). “Almost everyone is filled with the belief that he is debilitated,” wrote one exasperated physician in 1882 (qtd. in Shorter, Bedside 63). The travel industry catered to the invalid in search of health, with special vehicles such as the “invalid tricycle,” “invalid carriage,” and railway cars designed to accommodate the sufferer with special needs. Publishing houses rushed to meet the emerging market for guides specifically directed to the interests and “requirements” of the invalid abroad. Invalids populate the landscape of nineteenth-century fiction as well. Characters as different as the valetudinarian Mr. Woodhouse in Jane Austen’s Emma, the crippled but powerful Countess Neroni in Anthony Trollope’s Barchester Towers; bedridden Margaret May, moral center of the Evan-

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gelical novelist Charlotte Yonge’s The Daisy Chain; Margaret Dawson, the invalid around whom the various narrators of Elizabeth Gaskell’s collection Round the Sofa gather; mysterious and malicious Mr. Fairlie in Wilkie Collins’s Woman in White and bitter Mrs. Milroy in Armadale; and the patient made invalid by his physician’s overdrugging in Charles Reade’s bestselling novel It Is Never Too Late to Mend suggest something of the range of uses to which novelists found they could put the invalid. Perhaps most pointedly, at the century’s end Oscar Wilde created in The Importance of Being Earnest the hypothetical figure of Bunbury, an “invaluable permanent invalid” uncle who allegedly resides in the country, providing his creator, Algernon, with a ready-made excuse to escape from undesirable city obligations. In Wilde’s play, the term “Bunburying” becomes synonymous with lying.1 Yet if nineteenth-century novelists and playwrights poked fun at the invalid overly preoccupied with aches, pains, and bodily distress, they also found in the figure an emblem of sensitivity and insight. The invalid could stand for the threatening or duplicitous, but so too might he or she represent, as in Yonge’s vision, integrity and holiness. The fictional invalid might as easily play philosopher as fraud. Invalidism and Authorship Given the variety of these fictional roles and the range of the invalid’s cultural presence, it is perhaps no surprise that in the nineteenth century “the invalid” functioned as a legitimate authorial identity. Compendiums of bibliographic information reveal that narratives by invalids proliferated in Victorian England as in no other age. All but one of the narratives written anonymously by invalids listed in the British Library’s History of Printed Books were published between 1835 and 1891.2 Listings in Poole’s Index of Periodicals and in The Wellesley Guide to Victorian Periodicals similarly reveal a clustering of essays and articles written by invalids during Victoria’s reign. George Henry Lewes wrote in an 1864 Cornhill Magazine essay that “Whoso speaks on Health is sure of a large audience” (qtd. in Haley 3), but he may just as well have continued, “Whoso speaks on Ill Health is sure of one even larger.” 1. For exploration of the homosexual implications of Wilde’s term, see Christopher Craft’s Another Kind of Love: Male Homosexual Desire in English Discourse, 1850 –1920. Christopher Lane, in The Burdens of Intimacy: Psychoanalysis and Victorian Masculinity, takes issue with Craft’s interpretation. See esp. 230 –33. 2. The noteworthy exception is a Georgian spoof titled The Register of Folly: Or, Characters and Incidents at Bath and the Hot Wells, in a Series of Poetical Epistles. By an Invalid.

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If evidence abounds of a flowering of prose by invalids, explanations for the showing are less apparent. Although discussion of illness and infirmity can be found throughout the diaries and letters of men and women in previous generations, never before did protracted ill health stand alone as legitimizing authorship. As Peter Gay has written, “The theme that dominated the nineteenth-century personal letter was health, mainly the writer’s health, seldom perfect and normally compromised by complaints described with clinical details and in a matter-of-fact tone that speaks of resignation” (326). Commenting on the meticulous notes Charles Darwin kept in a journal devoted exclusively to his illnesses, Roy Porter and Dorothy Porter speculate that his predecessors, the Augustans, would have thought such chronicles “mawkish and unseemly” (In Sickness and in Health 12). Many Victorians evidently had no such qualms, nor did they restrict their concerns about health or evocations of affliction to their private diaries or their personal correspondence. Instead, they went public with their suffering, finding advice books, hymnals, inspirational works and commonplace books, travelogues, and tracts as well as more traditional literary forms equally amenable for reflection on suffering. Gift books and literary annuals routinely included works such as Thomas Campbell’s “Lines Written in Sickness” and the anonymous “Sickness: A Poem.” Widely read weekly and monthly periodicals such as the London Magazine, the Cornhill Magazine, Macmillan’s Magazine, and the Fortnightly Review are replete with essays bearing titles such as “The Convalescent,” “The Pleasures of Sickness,” “The Invalid’s World,” and “Literary Pursuits Recommended to Invalids.” Such periodicals also made frequent use of travel narratives written by and directed to invalids heading abroad in search of health. Almost any topic, in fact, could be approached from the purportedly distinctive perspective of the invalid, as suggested by the tract titled “A Few Thoughts on the Serious Character of the Objects of a ‘Yearly Meeting’ and on the State of Mind Suited to Its Engagements,” published by an anonymous, presumably Quaker, invalid. Harriet Martineau was one among several invalids to publish full-length studies of the invalid’s experience; praised by Eliza Follen for her “earnest desire to do what she could for her fellow-sufferers,” Martineau’s Life in the Sick-Room (1844) almost immediately went to a second edition (xi). Such published narratives hold special significance to this book, concerned as I am to examine the figure of the invalid as a recognizable type of person in nineteenth-century Britain with a particular kind of authority and to explore what the emergence of a public culture of invalidism tells us about this historical moment. The invalid was, of course, one of many cate-

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gories of people to occupy a prominent place in the nineteenth-century imagination; the fallen woman, the criminal, and the lunatic might also be said to have assumed special categorical status, and indeed this particular constellation of figures points to a correlation between the appearance of social types and more fundamental beliefs held by nineteenth-century society about the normal and the deviant. In “Making Up People,” Ian Hacking attributes early nineteenth-century culture’s propensity to create classifications into which to fit and enumerate people, its “medico-forensicjournalistic labeling” (233), to an obsession with “analyse morale” or “the statistics of deviance” (222). “Social change creates new categories of people,” he notes, “but the counting is no mere report of developments. It elaborately, often philanthropically, creates new ways for people to be” (“Making Up People” 223). Referring to this process as dynamic nominalism, Hacking’s theory helps one understand how the category of invalid may have opened up a spectrum of “possibilities for personhood” specific to the Victorian sufferer, opportunities that were manifestly unlike those accorded to other types (229). “Each category has its own history,” Hacking notes, echoing Amélie Rorty, who in The Identities of Persons reminds her readers that because the definitions of social entities “change historically, forced by changes in social conditions and in answer to one another’s weighty inconsistencies, there are layers and accretions of usages that can neither be forced into a taxonomy nor be safely amputated” (“Literary Postscript” 301). Such investigations of the notion of identity, rooted as they are in social psychology and the philosophy of science, provide useful ways to consider both the “possibilities for personhood” and the “weighty inconsistencies” that were signified by the label “invalid” as well as the significance of this identity to the culture that enabled it to secure status. This book explores narratives by people who considered themselves invalids (or were considered so) and attempts to elicit from those narratives something of the lived experience of invalidism. At the same time, however, it seeks to clarify how far their experiences were shaped by cultural meanings attached more broadly to the figure of the invalid itself, whether that figure took the form of author, subject, or character. Ian Hacking recommends considering the process in terms of two vectors: “One is the vector of labeling from above, from a community of experts who create a ‘reality’ that some people make their own. Different from this is the vector of the autonomous behavior of the person so labeled, which presses from below, creating a reality every expert must face” (“Making Up People” 234). Because many segments of Victorian society combined to create the “reality” of invalidism, the possibilities for what people could make of the label “invalid” were many

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and varied. Similarly, that many forms of bodily and mental distress compelled Victorian sufferers to believe they were invalids inevitably affected understandings of the identity generated “from above.” That the two vectors Hacking identified were in fact interactive is evinced in narratives written by Victorian invalids as well as in writing about them. John Addington Symonds, for example, took great delight in a periodical reference to himself as “the indomitable invalid,” 3 but in a letter to his friend Horatio F. Brown he bemoaned fellow writer Robert Louis Stevenson’s “habit as an invalid” (Letters and Papers 128). Symonds himself subtitled his Cornhill Magazine essay “Winter Nights as Davos” “Leaves from the Diary of an Invalid,” a term used at several points in his Memoirs to capture what were to him the mutually debilitating consequences of his consumption and his homosexuality. As these examples suggest, nineteenth-century society and the individuals within it both contributed to “making up” the invalid and were alike capable of appropriating the term to serve a wide range of purposes. To the extent that we think of the Victorian invalid as exemplifying a social type, a “made-up person,” narratives by invalids might be seen as “somatic fictions,” the term Athena Vrettos used to describe the writing generated by Victorian authors that enabled them to control seemingly chaotic or unmanageable social issues. Yet to make observations about how invalidism was used or manipulated to serve a variety of ends introduces important questions of authenticity into this project. To what extent did Victorian invalids suffer from real diseases and debilities, and how subject to manipulation were those diseases and debilities? In which cases were they symptomatic of what now would be called a psychosomatic condition? In which cases was invalidism a deliberately adopted posture, and in what circumstances was it then thought of as fraudulent? While in Somatic Fictions Vrettos argues that “psychosomatic illness provided the central instance” of the Victorian “process of imagining illness (or health),” she also warns that “this does not necessarily mean that the Victorian middle classes were hypochondriacs or valetudinarians” (181). Signifying both truth and fraudulence, the Victorian invalid raised for cultural consideration the very issues that scholars contend with today; plausibility, as Alison Winter writes, is “one of the hardest things for historians to reconstruct” (Mesmerized 353). Although the problems of retrospective diagnosis are many, they cannot be entirely 3. In a letter of 14 November 1892 from Symonds to his daughter, Margaret, he refers to it as a “splendid phrase” (779).

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avoided in a study of this sort.4 On this issue I find myself in agreement with Ian Hacking, who in Mad Travelers writes that “the impossibility of retroactive diagnosis is the academically correct, official history-of-medicine or philosophy-of-science teaching. But like many teachings that place great weight on propriety, this one contains more than a touch of self-righteous cant. We can say some things about old cases in the light of present experience” (87). What it seems most important to grapple with is not what medical condition(s) individuals known as invalids may “really” have suffered from, but rather what they assumed were the sources, symptoms, and consequences of their afflictions and what society believed about their personhood. In focusing on how invalidism as medical condition and as social role shaped the invalid’s status, and perspective as author in particular, an additional challenge will be to fully address the inconsistencies built into the invalid’s identity—that is, to explore what the figure’s association with oppositional concepts such as strength and weakness, submission and control, incapacity and command reveals about nineteenth-century culture and to assess how they influenced the invalid author’s narrative techniques and representational strategies. An interplay between individualized experiences of invalidism and the social role accorded to the invalid is everywhere in evidence in the varied lives of men and women who adopted the mantle, and the range of their roles and experiences in turn illustrates the inconsistencies seemingly inherent in the identity. Florence Nightingale, taking to her bed for nearly fifty years after her triumphant return from the Crimean War, both for retreat and to continue her work, cut a very different figure in Victorian society than did Edward Bulwer-Lytton, dashing off periodically to various water spas to rejuvenate his worn-out self. The experience of Ellen Chadwick, a woman who entertained and instructed hundreds of visitors to her sickroom and who came to be known as “the Famous Manchester Invalid,” was undoubtedly very different from the man or woman whose only public gesture was to write the “little volume” titled The Solace of an Invalid and still more from the myriad invalids who never thought to go public with their stories of affliction. Although Ralph Colp confidently titled his study of Darwin’s health To Be an Invalid, it is clear that “to be an invalid” could and did mean many things. Just because there were many forms of invalidism does not mean it is 4. For examples of careful diagnostic studies see Veith’s “The Recluse: A Retrospective Health History of Florence Nightingale” and Colp’s “More on Darwin’s Illness.”

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necessary to abandon the effort to define it more precisely. To begin to unravel the medical and social implications of the term “invalid,” we must first grasp the range of its denotative possibility and its multiple usages. The Oxford English Dictionary defines one adjectival form of the word as meaning “not strong, infirm, weak, inadequate,” and “not valid.” The related noun form is defined as “an infirm or sickly person.” The earliest documented usage of the term comes from a 1709 Tatler article that conveys well its association as a recognizable category of person: “Bath is . . . always as well stow’d with Gallants as Invalids” (35). This particular use of the term is also associated, according to the OED, with “anything damaged, dilapidated, or the worse for wear,” as well as with “a soldier or sailor disabled by illness or injury for active service,” both definitions with interesting implications for what the word may have connoted to Victorians. The term “invalid” also has a history as a verb that means, in its first usage, “to affect with disease or sickness; to make an invalid; to ‘lay up’ or disable by illness of injury” and that significantly is used chiefly in passive form. “Invalid” is also related etymologically to “invalescence,” defined in one instance as “the state of condition of being an invalid; ill health,” yet in another as “to be strong against” and “strength; health; force.” The multiple possibilities for meaning as well as the term’s seemingly inherent inconsistencies are alike important to an endeavor to understand Victorian versions of invalidism, but perhaps most significant are manifestations and uses of the term specific to the nineteenth century. Discussing the original association of “invalid” with soldiers and sailors unfit for active duty, Sheila Rothman notes that “by the nineteenth century the term came to encompass all persons, military or civilian, who were weakened by disease and lacked the strength to participate fully in daily activities” (22). According to Rothman, “Robert Louis Stevenson, himself an invalid, brought the older and newer definitions together when he labeled the group ‘the wounded soldiers of mankind’” (22). The OED traces the earliest use of the term “invalidish,” meaning “of the nature or character of an invalid; resembling an invalid, somewhat of an invalid” to 1853, with another recorded use attributed to an 1873 comment of George Eliot’s: “We have been invalidish lately.” Similarly, the earliest recorded use of “invalidism” to refer to “the state or condition of being recognized or confirmed invalid” is in 1794, and the two other illustrations cited in the OED (from Blackwood’s Magazine and from Holmes’s Hunt after Captain) are dated 1843 and 1862. A multitude of uses of the word as an adjective also seem to have erupted in the nineteenth century. The OED illustrates this usage through such examples as an “in-

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valid breakfast,” “invalid chair,” “invalid cookery,” “invalid furniture,” “invalid ships,” and “invalid feeding cups.” The lexicographic lineage of the terms “invalid” and “invalidism” reveals a long-standing association with infirmity and incapacity, but it is evident that in the nineteenth century that association came also to include the idea of a posture, a stance, a position taken, a role endorsed or embraced so as to become visible and therefore recognizable. Although Diane Price Herndl contends in her study of the figure of the female invalid in nineteenthcentury American literature that invalidism “referred to a lack of power as well as a tendency toward illness” (1), that so many British invalid authors used their narratives to proclaim the intellectual and creative power conferred by sickness or debility complicates the association of the term with lack and powerlessness. As Harriet Martineau gushed in her the chapter “Some Gains and Sweets of Invalidism” in Life in the Sick-Room, “To what soaring heights of speculation are we not borne up! What is there of joy or sorrow, of mystery and marvel, in human experience that is not communicated to us!” (196). The frequency with which the chronically afflicted were referred to as “confirmed” or “permanent” invalids, or more cynically as “semiprofessional” or “professional” invalids, also helps to refine our understanding of how invalidism was understood in Victoria’s day. These modifiers imply that notions of legitimacy and of personal and social acceptance were as crucial to the identity as were ideas of duration and endurance. Indeed, many invalid authors found themselves compelled to participate in the collective project of classifying themselves. As C. Home Douglas, author of Searches for Summer, a book “dedicated to British and American Invalids,” confidently proclaimed, “Invalids may fairly be divided into three classes: those who are organically and hopelessly diseased; those who are functionally diseased; and those who, having no disease at all, have come abroad to relieve the ennui of country residence with a little fun and flirtation, most legitimate objects in my opinion” (12–13). More terse was Emily Lawless, author of “A Renegade,” who began her essay with the statement that “invalids may be pretty accurately divided into two classes, those, namely, who are likely to live, and those who are likely to die” (350). Finally, the term “incurables,” sometimes used in medical discourse interchangeably with “invalids,” underscores the figure’s association with a segment of the population thought to be beyond the reach of medicine, whether professional, fringe, or lay. To the extent that individuals who came to be known as “invalids” inherited some of all of these associations, they

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might usefully be thought of as occupying what medical sociologists more recently have termed “the sick role.” Wilkie Collins captures this dimension of the invalid identity well when in “Laid Up in Lodgings” he writes, “I present myself at once in the character of a convalescent visiting Paris” (199). This book aims to articulate and assess Victorian versions of the sick role, to gauge the degrees of performativity evident in individual narratives while at the same time acknowledging the critical gaps between the figure of the patient and the figure of the invalid, whose more distanced relationship with institutionalized medical care alters the script accorded to the sick role in significant ways. In his influential study of modern medical practice, Talcott Parsons approaches sickness both as a “condition” and as a social role to which are attached, he contends, a set of institutionalized expectations with corresponding sentiments and sanctions. Numerous medical sociologists have expanded on and modified Parsons’s ideas since the publication of The Social System. David Locker, for instance, argues that illness “is essentially a moral category,” one that “involves judgments about the extent to which an individual has personal control over his actions” (179). By examining the Victorian invalid from the vantage point of the criteria enumerated by Talcott Parsons, we can tease out some of the important constituents of the invalid identity specific to the era. Key among the expectations he associates with the sick role are the following: exemption from normal social responsibilities; the presumption that the sick person cannot be expected to get well by an act of decision or will; the obligation to want to get well; and the corollary obligation to seek out competent help. Many scholars looking retrospectively at examples of Victorian invalidism have questioned how far particular individuals may have been “driven to bed” by a desire for exemption from social responsibilities. Some, for example, have argued that Florence Nightingale deliberately adopted the posture of an invalid in order to exempt herself from the expectations her family had for her as a young woman of a particular class and to enable her to work in the way she desired. Olive Banks describes the “habits of an invalid” that Nightingale maintained while living in seclusion this way: “Adopted at first out of necessity on her return exhausted from the Crimea, she maintained this lifestyle as a defense against those, including her family, who might otherwise have frittered away her time and energy” (141). Comparing Nightingale’s deliberate “adoption of the sick-role” to Elizabeth Barrett’s “unconscious response to unendurable family tensions,” Anne Digby makes the important point that “these women achieved an invalidism that was socially approved, not only because such a role was compatible with the Victorian bourgeois ideals of femininity, but also because it was financed privately” (278). This

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observation would certainly apply as well to Harriet Martineau, whose letters abound in references to the family members who attended her throughout her bedridden years at Tynemouth and at Ambleside and to their financial support of various medical treatments. As Digby writes, “In contrast, working women’s attempts to adopt a voluntary sick-role tended to fail” (278). Certainly the association with the idealized femininity of the middleor upper-class woman is evident in the many Victorian paintings featuring a young woman invalid either alone or attended by her concerned parents or physician. Representative in this regard is Hippolyte-Louis Garnier’s depiction of a female invalid contemplating her physician’s recommendation of medicine; her slack posture, like the drooping flowers in the vase beside her, demonstrates her need of revivification (fig. 4). Still, although the role of the invalid clearly had particular meanings and implications for women, its attractions—and implications—were not limited to them. Charles Darwin, for example, evidently admitted to taking advantage of his ill health to excuse himself from the daily obligations to socialize that would have interfered with his reading and study. As Cecil Woodham-Smith once summarized it, after noting that the great scientist “passed most of his life on his sofa,” “It was the life of an invalid, and what freedom it brought” (2). Yet if chronic illness excused some Victorian invalids from routine responsibilities, other social duties clearly came with the role. One such duty was to be receptive to sick visits. Christians from the times of the early Methodists onward adopted visiting the sick as a duty, and by the late eighteenth century and on through the nineteenth friendly societies and Evangelical female charities made visits to the homes of afflicted members (R. Porter and D. Porter, In Sickness and in Health 195). As Miriam Bailin writes, “Nursing the sick was, for both men and women, as sanctified an act as suffering itself ” (Sickroom 11). Visits to the sick among one’s friends and neighbors—obligatory for many middle- and upper-class women—would not have become customary daily or weekly routines were not the sick themselves expected to accommodate them. In her Notes from Sick Rooms, first privately printed in 1883, Julia Duckworth (Mrs. Leslie Stephen) included several pages of guidelines for visitors, with comments such as the following: “Most invalids have some hour when they may be visited, but it is in vain that they impress this fact on their friends,” and “There is a delusion under which most visitors to an invalid labour—that all illness affects either the brain or the hearing” (Stephen 27). Some invalids attempted to exert their own measure of control over who could visit and what their mission should be; the author of Letters from a Sick Room warned her readers that “not the least annoying among the many who come to do us good, are

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Figure 4. “A Physician Recommending Some Medicine to a Young Female Patient.” Colored lithograph by Hippolyte-Louis Garnier, after Jean-Louis Canon. Reproduced with permission of the Wellcome Library, London.

those who bring some new prescription, drug, or doctor, so earnestly setting forth the merits of each, that one would judge that all scripture were false, and man was not born to die” (85). Still, much literature of the period suggests that invalids were expected to be the willing recipients of a visitor’s inspirational thoughts and prayers.

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Indeed, the invalid addressed in Richard Mant’s Order for the Visitation of the Sick was, through a series of questions, exhorted to be patient and kind toward visitors. Mant instructed his fellow ministers to pose the following question to the sufferer: “Do you study to be as easy as you can to those who attend or minister about you; and to receive their well-meant care and services, kindly and thankfully?”(7). Mant’s version of the Order, incorporated into The Book of Common Prayer, also included “prayers, exhortations, and interrogatories” as well as other materials to “be profitably used by the Sick themselves.” Evangelical organizations issued a vast array of pamphlets providing the sickroom visitor with what Alison Winter has described as “stoic or fatalistic Biblical passages to read to the invalids under their care” (“Harriet Martineau” 606), and works such as F. C. Massingberd’s Hints on the Service for the Visitation of the Sick, G. W. Mylne’s The Sick Room: Or, Meditations and Prayers, for Sick Persons, and Sick Chamber Companion evidently found an audience. The Religious Tract Society published its own inspirational and “improving” series titled The “R.T.S.” Invalid Library.5 The literature of the period reflects a range of responses to this kind of material. For example, in her autobiography—first drafted in 1855 but not published until 1877—Harriet Martineau complained that “tracts and religious books swarm among us, and are thrust into the hands of every body by every body else, which describe the sufferings of illness, and generate vanity and egotism about bodily pain and early death” (1: 439–40). The lyric simply titled “Visitor” in William Ernest Henley’s long poem In Hospital implies that inspirational materials were received by the invalid with ambivalence at best. The last stanza of “Visitor” reads: In snow or shine, from bed to bed she runs, All twinkling smiles and texts and pious tales, Her mittened hands, that ever give or pray, Bearing a sheaf of tracts, a bag of buns: A wee old maid that sweeps the Bridegroom’s way, Strong in a cheerful trust that never fails. (9–14)

Becoming the unwelcome recipient of inspirational or improving “tracts” was not the only dimension of the sick role to inspire anxiety in some in5. Alison Winter notes the differences between the pamphlets issuing from Unitarian and Evangelical sources, with the first oriented toward the mortal world and the other far more directed toward preparation for the eternal (“Harriet Martineau” 606).

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valids. Although A. B. Ward in “The Invalid’s World” welcomed the visitor who was “the bringer of eatables” and described children as “apt entertainers,” judging them to be “satisfactory as any visitors are,” he bemoaned those visitors who “insist with forceful argument and friendly zeal on cramming some diabolical patent medicine down your throat, will you, nill you” and found still worse the visitor “who advances with a subdued air and looks into the face of the recumbent with the same expression which he, poor fellow, has seen her wear when she was performing her social duties at a funeral and looking into an open coffin” (“Invalid’s World” 70). The gentle humor with which Ward treats the visitor turns caustic in passages like this, revealing the bitterness that he and other invalids felt about the passivity of the sick role. Other criteria that Parsons associates with the sick role are less readily applicable to nineteenth-century experience than alleged exemption from social roles and obligations. Take, for example, the presumption that the sick person cannot be expected to get well by an act of decision or will. Alison Winter has demonstrated that mesmerism—closely associated with invalidism in its emphases on pain and the spiritual potential of the sickroom scene —enjoyed its celebrity partly because it seemed to demonstrate so overwhelmingly the power of the mind to control the body through an act of will. Harriet Martineau was only one of many to credit mesmerism with her release from the confines of a sickroom. Many invalids trumpeted the delights and unique advantages of being bedridden, as when Maria Edgeworth wrote, “I thank God not only for my recovery but for my illness. . . . [M]y illness was a source of more pleasure than pain to me” (qtd. in R. Porter and D. Porter, In Sickness and in Health 172) or when Alexander Shand extolled the “hours of delight and days of relief of which the invariably vigorous have no sort of conception” (547). That the pleasures of sickness were thought by many to be abundant suggests that the “obligation to want to get well,” another of the criteria Parsons set forth, was not necessarily as forcefully felt in Victorian times as it is in our own.6 Perhaps most significant, the Victorian “sick role” did not necessarily dictate that invalids seek out competent help. The anonymous author of Confessions of a Hypochondriac: Or, The Adventures of a Hypochondriac in Search of Health —whose title page indicates that the narrative was “By M.R.C.S.” (Member of the Royal College of Surgeons)—was one of many to 6. In a discussion of the American experience of invalidism in the nineteenth century, Sheila Rothman argues that “invalids had a very special duty to meet: they had to do everything possible to reverse the course of the illness, to rid themselves of the malady” (22). My research suggests that this imperative was far less prevalent in nineteenth-century Britain.

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Figure 5. “A Bedridden Sick Young Woman Being Examined by a Doctor, Accompanied by Her Anxious Parents.” Engraving by Francis Engleheart, after Sir D. Wilkie. 1838. Reproduced with permission of the Wellcome Library, London.

deplore the fact that the chronically ill were the “certain prey of the empiric” (57). The tensions that existed between professional and fringe medicine throughout the nineteenth century make considerably more complicated the questions of what constituted competency in medical care and of how beholden the chronically sick were to the medical market. In fact, the nineteenth-century patient was likely both to self-diagnose and to first seek help within the home. As Anne Digby summarizes it, “Lay sufferers . . . did not perceive questions of sickness or of recovery as being the sole gift of the professional but gave continuing importance to self-management” (303). Indeed, the figure of the invalid helped in a variety of ways to express deeply ingrained doubts about the ability of orthodox or alternative medicine to heal the chronically afflicted. Francis Engleheart’s 1838 engraving of a bedridden sick woman depicts a concerned physician whose tools and texts have failed both to cure his patient and to alleviate the anxieties of her parents (fig. 5). Doubts about the promise of medicine were not unique to the Victorian period. George Cheyne’s influential Essay on Health and Long

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Life had made the point that “only spiritual means” could ensure the calm deemed requisite for good health. Still, the message was both more pronounced in Victorian narratives directed to the chronically ill and, in some cases, more explicitly directed to challenging the claims of the emerging medical profession. The title of one tract published by the Society for the Promotion of Christian Knowledge, “The Only Cure,” nicely suggests just one of the ways that religious belief competed with the medical market to shape cultural attitudes about the place of suffering and appropriate responses to it. As one reviewer for the Home Journal wrote, discussing the author (and authority) of Mutterings and Musings of an Invalid, “He has clearly no need of a physician to ‘minister to a mind diseased’”(2).7 In a different spirit, Charles Edwardes, author of “Health-Resort Vignettes,” observed that most such visitors “spend all their time not occupied in eating and sleeping in seeking diversions of the most various kinds” and consequently “never trouble the doctors” (205). Competing cultural messages about suffering, its sources, and means of relief ensured that the invalid would occupy a fluid position within the Victorian taxonomy of illness and health. To the extent that invalids were thought to be convalescent or only “semisick,” they could be seen as moving along a continuum from illness toward the recovery of better, if not perfect, health. But an individual whose invalidism was “permanent,” “confirmed,” or “professional” might be seen to signify medicine’s inability to cure or, conversely, the invalid’s own resistance to recovery. Indeed, Harriet Martineau’s experience with extended illness demonstrates that the sufferer’s status as either permanent or recovering invalid was fraught with tension. Sufferers, their family members and caretakers, and their physicians were as likely as not to disagree with one another about prospects for recovery. For children especially, their general status as invalids subsumed more medically specific identities. Readers of Little Lucy, the Invalid, learn little about what has made her an invalid beyond that she has been weakened. In a series titled “Strolls with Invalid Children,” published in 1867 in Once a Week, Dinah Craik addresses her subjects simply as “my poor sick children.” A Chamber’s Journal article dated 4 July 1868 and titled “Invalid Dinner Tables” includes the following Dickensian passage: “‘I have heart-disease,’ answered Johnny Brown. And, ‘I am a consumptive,’ said a little girl, his neighbour. And, ‘Please, mine’s bronchitis,’ said the next. And, ‘Mine’s a white-swelling at my knee.’ And then there came heart-disease again, and 7. A series of excerpts from reviews of Mutterings and Musings of an Invalid appears at the end of Clouds and Sunshine.

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St Vitus’s Dance, and the too evident consumption of a poor pale hunchback, and a list of still other chronic diseases, till the piteous tale was told” (431). In most instances the significance attached to specific cases of invalidism was shaped by cultural beliefs about the diseases or debilities thought to have rendered the person invalid. Calling gout “the rich person’s status symbol,” Roy Porter and Dorothy Porter describe it as “a disorder of the leisured that provided further enforced leisure for reflection” (In Sickness and in Health 147). Social attitudes toward the consumptive invalid who traveled in search of health were very different from feelings toward someone brought down by “shattered nerves” or, still more, someone crippled in a factory accident. The Victorian invalid with assorted ailments who sought to persuade others of the healing potential of hydropathy adopted a very different posture than did the invalid who was uncertain of the source of his or her ailments but advocated a spirit of resignation and encouraged fellow invalids to find consolation within the pages of the Bible. Still more complicated was the invalid suspected of exaggerating the affliction to prolong the comforts of confinement. As A. B. Ward wrote in “The Invalid’s World,” “Illnesses magnified to win soft words and caresses, a lame leg handled as cleverly as ever the begging impostor in the street handles his—these are common enough among the creatures to whom we stand as patrons and benefactors” (67). Then there were those invalids whose particular afflictions were a mystery both to themselves and to their physicians. George Gissing’s description of Mrs. Thomas Barfoot in The Odd Women typifies many characters in Victorian fiction: “The lady always spoke of herself as a sad sufferer from mysterious infirmities, and had, in fact, a tendency to hysteria, which confused itself inextricably with the results of evil nurture and the impulses of a disposition originally base” (200). As typical is the description of Mr. Fairlie in Wilkie Collins’s Woman in White: “The doctors don’t know what is the matter with him, and he doesn’t know himself what is the matter with him” (51). Ellen Chadwick’s familiar epistolary refrain— “Dear friends, why I am thus detained in the school of affliction I cannot understand”—implies that only God truly understands her condition (69–70). Nineteenth-Century Invalidism in Context The competing cultural messages about suffering are thus vividly manifest both in the variety of social attitudes adopted toward invalids and in the range of causes attributed to invalidism. While no single watershed event occurred early in the nineteenth century to account for the development of the invalid and of a culture of invalidism, we can find explanatory matter in

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nineteenth-century medical, religious, and economic histories. Identities arise, Amélie Rorty reminds her readers, in highly specific historical contexts, but these contexts are nevertheless multilayered. Evangelicalism, the emergence of an industrial national identity and a concomitant middleclass, capitalist work ethic, self-help ideology, and the “rise” of professionalized medicine all worked in various ways to produce a climate in which the figure of the invalid could assume prominence and narratives about invalidism could prosper. Each in different ways helped to produce the kind of social change that, to return to Ian Hacking’s argument, let the invalid assume status as a recognizable category of person in nineteenth-century Britain and influenced attitudes about that kind of person. While it will be helpful to first examine these forces individually, it is important to think of them as functioning collaboratively, cumulatively, and in many cases intangibly to foster a culture of invalidism. Thus, just as Roy Porter and Dorothy Porter argue that the “‘coming-out’ of the hypochondriac as a cultural type” marks an important moment in medicine when “lay desires generat[ed] a medical consumerism integral to the wider development of market society” (In Sickness and in Health 209), so too must the emergence of the invalid as a social type both recognizable and ubiquitous be viewed as reflecting larger processes of cultural formation. Changes in the nineteenth-century medical market such as a restructuring of the doctor-patient relationship and the introduction of new diagnostic technologies were crucial to the formation of a culture of invalidism, but they do not alone command sufficient explanatory force to account for invalidism or, as critically, the appeal of the invalid’s narrative. Before turning to them, then, it is important to assay other features of early nineteenth-century culture that in important ways helped to foster invalidism. Chief among the features of early nineteenth-century culture is the Evangelical revival, which is often credited with prompting a widespread and substantial reformation of Christian practice in late eighteenth- and nineteenth-century England.8 Medical historians have charted a longstanding interaction between medicine and religion from the early modern period onward, documenting, for example, the centrality of medical meta-

8. Of the Evangelical revival Robin Gilmour writes, “A movement dating from John Wesley’s conversion experience in 1738, it was by 1800 operating in upper-case form within the Church of England (Evangelicals) and in lower-case form among the newly formed Methodists, through whose influence it passed to other Nonconformist groups (evangelicals)” (9). Gilmour makes the important point that the Evangelicals were always a minority and that “their success in converting an influential section of the aristocracy, and the undoubted influence this had on the manners of the aspiring middle classes, has to be set against the resentment that many of their activities caused” (10).

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phors to Christian discourse and the ways religion provided a language to express pain and sickness. Long before the Evangelical revival, Christian doctrine encouraged the devout to believe their illnesses were God-given. Roy Porter and Dorothy Porter summarize it this way: “Christian theodicy made sense of the lottery of life by treating pain and suffering as probationary in a cosmic epic started by Original Sin. Pain was due punishment for the Fall, and its constant reminder. . . . Yet orthodox Christians had to make sense of suffering. One resource was to see illness as a reprieve” (In Sickness and in Health 99). Just as religious belief often enabled people to make sense of sickness, so too did illness itself have the potential to solidify religious conviction. Discussing Puritan perceptions of illness, Andrew Wear concludes that “the merging of the two worlds of life and death, of body and soul, and the dual and interchangeable senses of Christ the physician, medicine and health, probably helped the sick to move easily from medicine to religion and vice versa, and reflects the fact that there was more than one mode of healing available in the seventeenth century” (“Puritan Perceptions” 69). Nineteenth-century Evangelicalism put its own distinctive spin on the attempt to make sense of suffering. Noting that the “Evangelical valorization of suffering coincided with the mid-Victorian domestic ideal,” Miriam Bailin rightly claims that it would be “difficult to overestimate the sway that the Evangelical reading of pain had over the Victorian representation of illness” (Sickroom 11, 10). Although she is specifically studying the nineteenth-century American experience of tuberculosis, Sheila Rothman’s general point about Evangelicalism is applicable to the British experience: “Evangelicalism had a particular appeal for invalids, and its influence in their life histories is marked” (57). While most manifest in the many laws, programs, associations, and philanthropic efforts devoted to social reform, Evangelical belief—in both Anglican and nonconformist forms—deeply influenced how individuals responded to the vagaries of their personal lives as well. The Religious Tract Society produced a series of tracts for its Invalid Library in order to provide comfort “in times of weakness and pain” (Preface). Beautifully illustrated and reproduced on linenlike cloth were texts such as “Hymns for the Time of Weakness” as well as short, highly moralistic works of fiction such as “Hetty’s Pretty Face,” which tells the inspirational and “improving” story of a young girl permanently scarred in a fire she had braved in order to rescue two cottager children (fig. 6). The invalid Ellen Chadwick wrote in a series of letters addressed to her “Christian Friends” that “God has a definite plan for the life of every child of His,” something she “had to learn in the school of a long and trying affliction”

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(111). Across the Atlantic in America the author of Letters from a Sick Room explained at greater length: “We are not exposed to the temptations of the busy world, though Satan is ever present, suggesting rebellion, impatience and unholy desires. Active duties, we know, are not required of us, for God never requires what it is not in our power to perform. Social obligations are not devolved upon us, but we have much time to cultivate a spirit of prayer, and we are assured that ‘the fervent effectual prayer of the righteous man availeth much’”(52). Such examples suggest the power of Evangelicalism not only to shape invalids’ own assumptions about their personal experiences with suffering but also to confer upon them the moral authority to share their hard-won wisdom with others. Serious or protracted illness was widely believed to promote conversion, the doctrine most central to Evangelical theology. Evangelical beliefs in the spiritual transformation that followed conversion also dovetailed with beliefs about bodily and psychic transformations within the sickroom. Ian Bradley writes in The Call to Seriousness: The Evangelical Impact on the Victorians, “Those who had undergone the ‘great change’ regarded themselves essentially as pilgrims and strangers on earth, in the world but not of it” (28). And indeed many invalids were led, like Harriet Martineau, to see themselves as “pilgrims of pain,” sequestered within the otherworldly space of the sickroom. Whether confined by illness to a sickroom or banished from Britain to a different climate, the invalid occupied such a position in the world yet not of it.

Figure 6. “Hetty’s Pretty Face,” from The RTS Invalid Library. 1896. Reproduced with permission of the British Library, London.

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Figure 7. “A caricature of an invalid strapped into a special chair; next to him is a table full of medicine bottles.” Reproduced with permission of the Wellcome Library, London.

Victorian illustrations and sketches of the sick and suffering corroborate the scope of an Evangelical-inspired “call to seriousness.” Whereas Georgian artists found in their satiric representations of gouty, drug-addicted, and self-indulgent invalids a way to critique the foibles of the wealthy, the greediness of the physicians and apothecaries they indulged, and the gullibility of the ill (fig. 7), Victorian artists more often depicted authentic suffering, with the sick and dying confined to sickrooms darkened to suggest their diminished prospects for recovery. Typical is the woodcut labeled simply “Watching,” which appeared in a story installment titled “Trust Me” in the November 1872 issue of the Cornhill Magazine; here the bedridden invalid, head partly hidden behind bed curtains, is depicted as an object of his visitor’s worry and concern (fig. 8). The popular 1891 painting by Luke Fildes, “The Doctor,” also typifies the trend in its depiction of the sick person (in this case a child) watched over by an anguished family member and

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Figure 8. “Watching.” This illustration appeared alongside an installment of “Old Kensington” in the November 1872 issue of the Cornhill Magazine.

a deeply concerned physician.9 Representative also is an untitled watercolor by Ambrosini Jérôme that depicts a female patient, attended by her physician and her mother, whose otherworldly gaze is directed through her window to the beyond (fig. 9). Much of the iconography of invalidism suggests that extended or acute illness was assumed to be conducive to the self-examination and soulsearching necessary to those charting the progress of their spiritual journeys. “That they might be privileged to live useful lives was the most sincere prayer of all Evangelicals,” writes Ian Bradley, and narratives by invalid believers reflect a desire to posit invalidism itself as beneficial. “The word invalid—in-valid—means of no use,” wrote C. Howard Young, author of Sunny Life of an Invalid. “In God’s world, the word is a misnomer; everything has its use” (101). Believing that God called them not only “to a life of Bible 9. For discussion of this painting, see Anne Digby’s Making a Medical Living. Digby notes that “the doctor is depicted as dedicated and disinterested; prepared to spend time with the patient, even if the material reward from this poor family was likely to be negligible. Equally, there was acknowledgement of the doctor’s inability to save the child’s life, despite his best efforts, and the anguish that this caused him. The portrait was thus a brilliant synthesis: sufficiently realistic—in depicting a common predicament—to gain recognition as an honest portrayal, yet sufficiently idealised to appeal to medical practitioners’ self-image of what they wished professional life was like” (312).

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Figure 9. “A Sick Female Patient,” by Ambrosini Jérôme. This watercolor depicts a physician taking the hand of a sick female patient while her mother stands nearby. 1870s. Reproduced with permission of the Wellcome Library, London.

reading, prayer, and reformed habits” but also to spreading the gospel to others, scores of invalids were prompted to find ways to serve their fellow sufferers, to make their invalidism useful (Krueger, “Clerical” 146). The editor of Ellen Chadwick: The Famous Manchester Invalid was “encouraged by the great usefulness” of her books to reissue them, and the anonymous author of The Solace of an Invalid compiled the volume “at the request and for the use of a friend severely suffering in a long-protracted illness” (vii). The author of Letters from a Sick Room proclaimed with delight, “What a precious

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privilege is afforded us of imparting knowledge, of elevating others, and inciting them to prepare for more extensive walks of usefulness” (53). Many invalid authors not explicitly promoting a Christian agenda felt similarly compelled to attest to their desire to serve others, and their prefatory declarations testify to the reach of the Evangelical spirit beyond members of its various sects. In the preface to his Life at the Water Cure: Or, A Month at Malvern, to cite just one example, Richard Lane defensively announced, “I present an earnest and a faithful record, in the full conviction that I am assisting in a great and good cause; without which ruling motive, no ‘consideration’ could have tempted me to entertain, for one moment, the idea of ‘going to press’” (vi). Being useful, even in illness, was further protection against the charge of malingering; to be confined to one’s bed or chair was not necessarily to be idle, one of the sins foremost in the Evangelical imagination. “I consider it sinful for us to sit idle all day long,” wrote the author of Letters from a Sick Room (23). Evangelicals were not the only ones to attach to idleness the stigma of sin. Charles Darwin is said to have pronounced, “I would sooner be the wretched contemptible invalid, which I am, than live the life of an idle squire” (qtd. in Colp, To Be an Invalid 105–6). Less dramatic was Emily Shore, who simply bemoaned the rest from activity that her doctors and family demanded of her; “I am told that I am not giving myself fair play,” she wrote after being chastised for attempting to study. “I am sorry that idleness is necessary to my doing so” (171). Another indication of nineteenthcentury culture’s anxious identification of invalidism with the stigma of idleness is to be found in Little Lucy, the Invalid: Or, Nursery Dialogues (fig. 10). In this text the eponymous heroine’s brother William warns her to “take care, or you certainly will become very idle” (67). She immediately responds, “Indeed I am not idle, William, nor growing idle either. I have begun my lessons again this week, and do more of them every day; and mamma says she does not find me much gone back” (67). The anxiety reflected in the desire of so many invalid authors to declare themselves or their narratives useful exposes how a newly emerging work ethic associated with an industrializing, urbanizing society and the ascendancy of the middle classes also helped shape the invalid identity.10 This anxiety goes some way toward explaining the seeming paradox of Victorian invalids who, like Florence Nightingale, in invalidism embarked on “a life of 10. Although José Harris is undoubtedly right to argue against a “homogeneous Victorian ‘work ethic’” (125), beliefs about the importance of working hard were nevertheless widely held by the middle classes of Victorian society.

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Figure 10. “Little Lucy, the Invalid.” In this engraving produced for Little Lucy, the Invalid (1835), the child ventures outdoors for some air and change of scenery; her governess protects her with a parasol. Reproduced with permission of the British Library, London.

almost uninterrupted exertion” (Bailin, Sickroom 34). It underwrites comments such as those Harriet Martineau made to her friend W. J. Fox after determining on a course of mesmerism: “The broad line is passed,—between uselessness & usefulness. I feel that I can work again,—whenever I get leisure; & this is all I care about” (qtd. in Sanders, Harriet Martineau 101). Anxiety about fulfilling a work ethic is evident even in invalid narratives of convalescence, as when Richard Lane comments that “the desire to lie a little longer is checked by a sense of inglorious inactivity” (261). Many invalids embarking on a “search for health” found themselves similarly compelled to reconcile the association of travel with escape and leisure with a mission of usefulness. The “pillar of social, economic, and moral life” in nineteenth-century England, work became for many, in José Harris’s estimation, “an all-absorbing psychological passion” (123). The production of useful, creative labor was, in Bruce Haley’s view, one of the foremost ways Victorians recognized health. Crediting Evangelicalism with helping to elevate the concept of work in nineteenth-century England, Davidoff and Hall observe that “work was not to be despised, rather it was to be seen as doing God’s duty in the world” (111), a view that helps to explain why Victorians so frequently con-

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strued work as serving spiritual ends. “One more day’s work for Jesus,” chant girls in The Bitter Cry of Outcast London, and Thomas Carlyle paid homage to the “Captains of Industry” in Past and Present by writing that “the mandate of God to His creature man is: Work!” (166). In his lecture titled “Work,” delivered to the Working Men’s Institute and reprinted in The Crown of Wild Olive, John Ruskin pontificated as follows: “Work first—you are God’s servants; Fee first—you are the Fiend’s” (43). The intensity with which work was glorified in Victorian culture was matched by the shame attached to not working, particularly for those in the laboring classes. The stigma of unemployment is captured in the fourth volume of Henry Mayhew’s magisterial study London Labour and the London Poor, titled Those That Will Not Work.11 Accelerating as it did in the early years of the nineteenth century, industrialization had an inevitable effect on family life and household structure. Historians have thoroughly documented the impact of industrialization on the forms, hours, and intensity of physical forms of work, and in Victoria’s day philanthropic concern, worker agitation, and the activity of trade unions combined to ensure that conditions of life for the working classes occupied a prominent place in public discussion. Because industrialization spawned the phenomenal growth of the working classes, it is not surprising that historians of the period have concentrated on them. Still, as José Harris points out, “the history of work cannot . . . be reduced to the history of the working class; work was the central reality of social life for the vast majority of people” (48). The conditions, practical meaning, and symbolic significance of work for the middle classes all have a direct relation to the culture of invalidism. Victorian proclamations of the holy nature of work competed with a class consciousness that still attached a certain amount of status to the idea of not having to earn one’s living. Such class consciousness was in turn influenced by considerations of gender, particularly since some believed that the greatest stigma attached to middle-class women who had to work. Of Dr. Madden in The Odd Women, Gissing writes, “The thought . . . of his girls having to work for money was so utterly repulsive to him that he could never seriously dwell upon it” (33). If, as Haley contends, the Victorians believed useful labor to be symptomatic of health, it is equally arguable that nineteenth-century sufferers devised multiple ways to make illness productive. Robert Brett’s Devotions for 11. For more detailed discussion of the types of people included in this part of Mayhew’s investigation and of its implications for an understanding of nineteenth-century social attitudes to the unemployed, see John Burnett’s Idle Hands: The Experience of Unemployment, 1790 –1990.

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the Sick Room and for Times of Trouble advised sufferers to pray “to be fit for the night in which no man can work” (52), and many an invalid seems to have responded by finding ways to represent suffering itself as a form of work. Although invalidism may have signified an incapacity for exertion (and hence work), prominent invalids such as Florence Nightingale and Charles Darwin seemed to demonstrate otherwise. Nightingale’s sickroom was described as “a hive of industry” (Pickering 132), and Ralph Colp reports that “by rigidly adhering to his daily routine of work and leisure, by thinking about his work in some of his periods of leisure, and by working intensely in his brief work periods, Darwin was able to do a prodigious amount of work—perhaps more work than most of his illustrious contemporaries” (To Be an Invalid 106). Robert Louis Stevenson’s mother marveled that her son had “written at the rate of a volume a year for the last twenty years, in spite of weakness which most people would have looked on as an excuse for confirmed invalidism” (Letters from Samoa 327). While most “ordinary” invalids cannot be said to have followed the example of these celebrated intellectuals, many nevertheless found in illness the opportunity for some form of exertion, whether by producing travel guides for fellow invalids searching abroad for health, by putting together consolation texts designed to provide spiritual sustenance to their fellow bedridden, or by writing books designed to educate the healthy about the habits, needs, and emotions of the chronically afflicted. If authorship provided many with a way to demonstrate their usefulness as invalids and to embody a kind of exertion, invalidism still maintained a powerful connection with incapacity. Complicating still further the association between invalidism, productivity, and work, some invalids were believed to have been made invalid by work (more specifically, I will suggest below, by “overwork”). Although the idea was most obviously applicable to working-class invalids such as William Dodd (crippled by work in a factory) or Ellen Chadwick (succumbing to life as an invalid after having worked in a mill), middle-class invalids—particularly men—were nearly as likely to believe that the source of their debility was the workplace. Having let the “wear and tear” of their occupations make them subject to invalidism, such men could hardly been charged with avoiding work by feigning their illnesses, but many nevertheless expressed discomfort with prolonged convalescence. The so-called professional or confirmed invalid was thought to have made invalidism a kind of work, one that perhaps necessitated frequent trips to the doctor or journeys abroad to warmer climes. Alice James was said to speak “on behalf of several generations” when she declared that “invalids had the ‘life long occupation of improving’” (qtd. in Rothman 23).

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Taken together, such examples suggest that the figure of the invalid was inevitably positioned along a continuum defined by production at one end and waste at the other. Just how individuals might negotiate their places along this continuum would depend on many other variables, though. Not least, such important components of identity as gender and class would dictate not just different working conditions but also different standards for measuring productivity, different ways of demonstrating capability, and different forms of leisure. To cite some of the ways that ideas about middle-class work were associated with invalidism is not to suggest that invalidism was exclusively a middle-class condition. Nor, indeed, is it to posit too precise a sense of what populations or attributes are denoted by “middle class.” Working-class diaries and autobiographies throughout the period are replete with discussion of the vicissitudes of health and make ample reference to bouts of invalidism. Jane Andrew’s Recorded Mercies, for example, records the tribulations that ensued after an extended illness left the author “laid by,” a cripple. The Journal of William Swan details “a life of persistent ill-health and injuries [that were] compounded by the ‘disgrace’ caused by fathering an illegitimate child and by the difficulties of housing, feeding and clothing a growing family” (Burnett, Vincent, and Mayall 304). William Dodd published his Narrative of the Experience and Sufferings of William Dodd, a Factory Cripple to expose “the hardships and sufferings he endured in early life” (title page). In his narrative, Dodd charts his transformation from “a fine, strong, healthy, hardy boy, straight in every limb, and remarkably stout and active” to one whose health is undone by manual labor (272). As he summarizes, “Thus year after year passed away, my afflictions and deformities increasing” (280). Dodd’s narrative even made its way to the House of Parliament debates on the hours of labor in factories. Despite individual examples of working-class invalids and the many references to chronic ill health to be found in the diaries and letters written by working-class people, the public figure of the invalid nevertheless is most frequently associated with the middle classes. While Talcott Parsons has described the “sick role” as “a ‘contingent role’ into which anyone, regardless of his status in other respects, may come” (438), it is clear that the invalid role was most accessible to middle-class Victorians. The tensions produced by the ideological conflict between viewing work as insurance against suffering and yet seeing it as a cause of ill health rendered especially multivalent the middle-class experience of invalidism. Perhaps because middleclass work—particularly, but not exclusively, that considered to be “brain work”—was believed to be less physically demanding than work performed

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by laborers, the need to devise ways to dissociate it from idleness was felt more acutely and expressed far more frequently. Middle-class invalids developed distinctive rhetorical strategies for distinguishing themselves from the working classes. As Peter Logan explains, “The nervous body was a paradigm that the middle class used to explain itself to itself and to differentiate itself from other classes” (4). For the middle classes, to be considered idle was to risk an association with the shiftlessness, helplessness, and dissipation that working-class unemployment and idleness connoted (Burnett 5). The New Poor Law of 1834 in fact hinged on a concept of “able-bodiedness,” in turn defined by the ability to support oneself through gainful employment (Levine-Clark). While there are many reasons to associate a Victorian culture of invalidism with the middle classes, the preeminent one is that the figure of the invalid, so often imaged as incapable of work or as debilitated by work, raised the specter of idleness. Whether associated with workingclass malingerers or with the dissipations and ennui of the leisured (and therefore “idle”) classes, idleness threatened the respectability of the middle class. “It is idleness that is the curse of man—not labor,” wrote Samuel Smiles in a section titled “Work” written for Self-Help. “Idleness eats the heart out of men as of nations, and consumes them as rust does iron,” he went on. Articles with titles such as “The Danger of Idleness” were staple features of the weekly Penny Magazine. Ralph Colp notes Darwin’s resolve not to “waste one hour of time” and quotes his complaints of being “much unwell & scandalously idle” (“More on Darwin’s Illness” 222, 223). Most invalid authors countered the perceived charge of idleness by arguing for the usefulness of their narratives, but a few, like Robert Louis Stevenson, decried the cultural stigmatizing of idleness. “Idleness so called,” Stevenson wrote in his 1877 essay “An Apology for Idlers,” “does not consist in doing nothing, but in doing a great deal not recognised in the dogmatic formularies of the ruling class, [and] has as good a right to state its position as industry itself ” (80). Later in the essay Stevenson argues, albeit sardonically, that “extreme busyness, whether at school or college, kirk or market, is a symptom of deficient vitality; and a faculty for idleness implies a catholic appetite and a strong sense of personal identity” (83). The association of work with middle-class respectability was, predictably, gendered. Work provided middle-class men in particular with the opportunity for economic independence and public status that their respectability rested on. Evangelical underpinnings endowed work with dignity, seriousness, and all that could be considered “properly masculine” (Davidoff and Hall 112), and it was inextricably linked to national pride as well. “The freedom of an adult male to work as hard and as long as he wished was

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viewed for most of the nineteenth century as a cardinal tenet of civil liberty” (Harris 123). A man’s choice of a profession to work hard at was also inevitably linked to a concept of the gentleman no longer exclusively defined by aristocratic notions connecting honor to landed property and chivalric ideals. Rather, the gentlemanly ideal expanded throughout the century to include not simply the clerical, legal, and military professions and members of Parliament but also any educated man whose manners and sense of integrity adhered to the gentlemanly code (Perkin 84; Mitchell, Daily Life 269–70). The capacity to succeed, or seem to succeed, at work was integral to the gentleman’s identity. Not surprisingly, this moral imperative posed a special problem to the male invalid, no longer able to perform in the workplace but nevertheless anxious to maintain his gentlemanly status. When the author of Mutterings and Musings of an Invalid went on to write Fancies of a Whimsical Man, a reviewer praised him for restoring his manliness: “The invalid has laid aside his chamber negligee and come forth as quite a stout and eupeptic man” (3).12 Exhibiting stoic self-control under the pressure of enforced confinement was one of several rhetorical strategies invoked by male invalids attempting to preserve their status. Describing Robert Louis Stevenson’s Child’s Garden of Verses, John Wilson Bowyer and John Lee Brooks wrote, “Courage, ambition, and optimism, qualities which in his invalid’s life he strove to exemplify, were the topics of these songs” (764). Describing himself as an “old chronic” did not prevent A. B. Ward from writing, “As for Homeopathy and Allopathy I must confess to a mature, masculine preference for sound, smacking doses. I like to feel that I am using big guns and plenty of powder” (61). Not all male invalids, of course, felt such pressure to perform their manliness. Recollecting his father’s habits as an invalid, Sir Francis Darwin wrote, “After dinner he never stayed in the room, and used to apologise by saying he was an old woman who must be allowed to leave with the ladies. This was one of the many signs and results of his constant weakness and ill-health” (qtd. in Pickering 57). Manliness was implicated in Victorian beliefs about work that shaped male invalids’ rhetorical strategies in other ways as well. Herbert Sussman has shown how Ford Madox Brown’s painting Work, a pictorial celebration of a Carlylean ideal of work, reveals the ideological gap between muscular work, imaged as masculine and connected to the working class, and “brain work,” associated with “passive, feminized contemplation” (Victorian 12. Portions of this review appear in the “Books Published by John S. Taylor” section that appears at the end of the anonymous Clouds and Sunshine.

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Masculinities 40 –41). Brown idealistically describes Carlyle and F. D. Maurice, depicted on the sidelines in the painting, as only “seeming to be idle” but in fact functioning as “the cause of well-ordained work and happiness in others” (Sussman, Victorian Masculinities 41). Richard Lane, author of Life at the Water Cure, offered his own version of “only seeming to be idle” when he explained that his “occupation, although inactive, could not be called sedentary—for [he] never sat; nor did [he] perceive until the year 1840 (when [he] had kept up the habit of standing for twenty years, the least symptom of failing strength in [his] legs” (3–4). Despite such testimonies to the physical demands and burdens of middle-class “brain” work, Romantic heritage and the culture of sensibility exerted a powerful hold on the association of intellectual activity with the passive and feminized, linking these traits indelibly to weakness, vulnerability, and ill health without necessarily compromising the overall presumption of “manliness.” 13 The connection between beliefs about kinds of work, a work ethic, and invalidism in nineteenth-century Britain can be seen especially vividly in the condition of “shattered nerves,” particularly in the figure of the man made prostrate through overwork. Jenny Bourne Taylor and Sally Shuttleworth describe Charles Henry Felix Routh’s On Overwork and Premature Mental Decay: Its Treatment as one of a “spate of similar books on the dangers of overwork leading to the draining of ‘nervous force’ from the body’s internal economy” (300). In his essay “Joubert,” Matthew Arnold renders well the figure of one prey to such dangers: “Often, after overwork in thinking, reading, or talking, he remained for days together in a state of utter prostration,—condemned to absolute silence and inaction” (174). Numerous Victorian novelists seem to have latched on to the concept eagerly as well. Introducing Ovid Vere to readers of Heart and Science, Wilkie Collins wrote, “He had received a warning, familiar to the busy men of our time — the warning from overwrought Nature, which counsels rest after excessive work” (45). Explaining Alan Ernescliffe’s physical condition after returning to England from military duty, Charlotte Yonge wrote in The Daisy Chain of his fatigue from his service amid “sickness and death,” the concomitant pressures “of mind and body,” and the toll exacted by his having taken his examinations immediately upon his return: “His nervous excitable 13. For an elaboration of this theme, see Nicholas Roe’s “The Romance of Sickliness: Leigh Hunt’s Autobiography and the Example of Keats.” Roe traces the associations between passivity, femininity, and ill health in Hunt’s autobiography to Edmund Burke’s Philosophical Inquiry into the Origin of Our Ideas of the Sublime and Beautiful and its emphasis on the “weakness and imperfection” of women and the idea of “beauty in distress” (75). See also G. S. Rousseau’s “Nerves, Spirits, and Fibres,” John Mullan’s Sentiment and Sociability, and G. J. Barker-Benfield’s Culture of Sensibility.

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frame had been over-tasked, and the consequence was a long and severe illness” (10). Given the long workdays said to be typical for all levels of society (Harris 120), the incidence of overwork should not be a surprise. Janet Oppenheim explains the practical and ideological implications of overwork as follows: “Since men had to compete day after day in the market place; since they toiled year in and out on behalf of their families; since they coped with physical strain and intellectual demands that women never faced, it was entirely understandable that excessive exertion occasionally led to the depletion of their nervous resources. Men broke down, according to medical argument, because they simply overdid the striving for achievement that society honored” (152). Oppenheim traces the argument that modern life and its pressures for economic success were responsible for the rise of neurotic illness and bodily decline to Georgian texts but notes that it had become “a familiar medical theme by the 1830s” and that “after mid-century, the point was made with particular insistence” (153). The overlapping of the Evangelical revival and this particular dimension of medical history is captured particularly well in a story titled “My Doves” that appeared in The “R.T.S.” Invalid Library. Appearing in a question-and-answer section at the end of the story is the following: “Are you tired and overworked? Jesus says, ‘Come unto Me, all ye that labour and are heavy laden, and I will give you rest.’” The prostrate male may have been physically overtaxed, but the “overwork” that debilitated him may just as easily have been mental. Charles Darwin’s spa doctor James Gully identified “intellectual labour and moral anxiety” as chief causes of the dyspepsia to which many of his patients, including Darwin, had succumbed (Browne, “Spas and Sensibilities” 108), and Darwin himself described the work that went into the Origin of Species as “the main cause of the ills to which [his] flesh [was] heir to” (Colp, “More on Darwin’s Illness” 225). “Over-strenuous labour or exertion of the intellectual faculties” was a constitutive feature of “the wear and tear complaint” and of its cousin, the “overwork and worry theory” of male nervous breakdown. “The Wear and Tear of London Life,” Robson Roose’s Fortnightly Review essay, captures the flavor of discourse percolating throughout the Victorian era in its attention to degrees of capacity and incapacity, the toll of mental labor, and the consequences of overtaxing one’s “nervous energy.” Similar medical language inflects the narrative of Confessions of a Hypochondriac, whose anonymous author reported that “too much work and the hurry and worry of trade had overstrained [his] nerves and exhausted their tone.” John Addington Symonds was one among many invalids of the period to obsess throughout his

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life about work—his own and others’. Although he cautioned his friend Henry Sidgwick to “be less anxious about work,” saying “after all work is not everything” (Letters 2: 977), his personal writing reveals a profound inability to take his own good advice. Symonds’s letters and his memoir are riddled with references to work and overwork and full of conflicting attitudes about their relation to his overall health. Remembering that at Harrow and Oxford he was “always on the verge of falling into invalidism,” Symonds partially attributed his “irritable nerves” and the “peculiar erethism of [his] sexual instincts” to having “continuously overworked [him]self ” (Memoirs 230). Yet he was also disposed to connect occasions when his health suffered with the neglect of his work (Memoirs 98). In her discussion of “manly nerves” and the occurrence of “overwork,” Janet Oppenheim concludes that “in their sustained deprecation of overwork, nineteenth-century medical practitioners reflected a conflict between personal and communitarian goals, between autonomy and altruism, that Victorian culture never resolved” (158). Individual invalids seem not to have resolved the issues either. Although the medical community was inclined to diagnose overwork as a male problem, it was not exclusively so. Gissing’s novel The Odd Women is one of many that depict the dangerous consequences of work for women; in it, the doctor summoned to attend Monica Madden attributes her “nervous collapse, hysteria” and “general disorder of the system” to “consequences of overstrain at her old employment” (126). Florence Nightingale’s selfdescription as “an incurable invalid” who is “overwhelmed with business” is a potent reminder that invalidism, while believed to be a symptom of “overwork,” could also be manipulated to provide opportunities for work. The author of Letters from a Sick Room describes just such a situation in her section “Employments,” which includes the example of a “young lady, whose state of health during many months prohibited all exercise and precluded even the use of the needle” (22): “Many a ponderous folio did she examine, when others, with more strength, would have thought themselves only able to turn the pages of a light magazine; and instead of attempting to learn the nature of man by tracing a few facts woven into a tissue of falsehoods, she studied the authentic history of mankind. It was labor, but of a healthy and invigorating kind, producing no unnatural excitement to enfeeble the intellect and debase the passions” (22–23). Here the author attempts to justify the lady’s pursuit both within standards established by domestic ideology and through related ones more familiarly associated with institutionalized medicine. Rejecting her family’s evident sense that she was overworked, Florence Nightingale caustically described the laziness exemplified by her sister and

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mother as a “scene worthy of Molière, where two people in tolerable and even perfect health, lie on the sofa all day, doing absolutely nothing and persuade themselves and others that they are the victims of their self-devotion for another who is dying of overwork” (qtd. in Pickering 128). Yet plenty of women invalids, unlike Florence Nightingale, were willing to accept the diagnosis of overwork and to behave accordingly. When the Poor Law inspector Jane Senior wrote to Frances Power Cobbe in November 1874, she complained that she was “worked out, & forced to give in” to an “invalid life” that, her doctor advised her, would help to restrengthen her. Women working within the public sphere were not the only ones susceptible to overwork, debility, and invalidism. Although the Victorian period has long been credited with enforcing an ideological separation of home and work, and even with an increase in household servants, women in the middle classes were in fact responsible for much of the housework and child care (Davidoff and Hall 388). Even with a strong support system of friends, family, and neighbors, a woman’s extended period of illness or debility could wreak havoc on domestic order. Discussing the social expectations an invalid would be exempt from, Sheila Rothman notes that “invalids were allowed to modify, or in the extreme case, to avoid the obligation to earn an income or to fulfill the duties of wife and mother” (22). This kind of “modification” of duty is evident in some of the advice books written by women invalids early in the century. These women, finding that their invalidism did not prohibit them from fulfilling their spiritual mission, created narratives of domestic work that enabled them both to achieve their goals of spiritual and moral education and, less directly, to compensate for their own debility. Although Anna Williams, author of Hints from an Invalid Mother to Her Daughter, found herself “precluded by ill health from accompanying [her] children on their entrance into the world,” she determined nevertheless to exert moral influence: “Thus shall I still, though unseen, be heard; my warning voice shall accompany you; and, though isolated from the busy scene of worldly affairs, a mother’s affection induces her to point out to her child the snares and dangers of the road, and a mother’s tenderness to direct to a shelter from the pitiless storm” (2). Advice manuals like this one demonstrate what Nancy Armstrong has called “Labor that is not Labor” (75).14 By virtue of her ill health, the invalid mother effortlessly fulfills the standard conduct book requirement of a pas14. Armstrong argues that “as conduct books differentiated the woman’s ideal role from both labor and amusement, they created a new category of labor. One finds that while these books elaborate all of the tasks that can be called domestic duty, they still represent the woman of the house as apparently having nothing to do” (79).

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sive and retiring woman, yet she manages through her narrative to simultaneously embody the capacity to supervise central to the middle-class womanly ideal. For wealthy women whose lives were not determined by their domestic labor, extended illness posed problems nevertheless. In “The Little Health of Ladies,” Frances Power Cobbe grappled with “that condition of petite santé, valetudinarianism, and general readiness to break down under pressure, wherein a sadly large proportion of women of the higher classes pass their years” (98). Lashing out against the Romantic association of ill health with genius and her own era’s association of women with a fragile sensibility, Cobbe bemoaned the “lingering survival amongst us of the idiotic notion that there is something peculiarly ‘lady-like’ in invalidism, pallor, small appetite, and a languid mode of speech and manners” (“Little Health” 104). Barbara Ehrenreich and Deirdre English argue that “the boredom and confinement of affluent women fostered a morbid cult of hypochondria—‘female invalidism’ that began in the mid-nineteenth century and did not completely fade until the late 1910s” (17). This “morbid cult of hypochondria” is of course related to the emergence later in the century of neurasthenia, a diagnostic category that came to subsume many illnesses associated with protracted suffering. Elaine Showalter traces neurasthenia to incidents of overwork in American male intellectuals and businessmen. In importing the term to apply to a younger, female population, English psychiatrists “maintained that neurasthenia was ‘neither a modern nor an American disease only’ but simply a new name for what they had long called spinal irritation, neuralgic disease, or nervous weakness” (Showalter, Female Malady 136). Through much of the nineteenth century, however, all women were subject to the widespread medical assumption that the biological phases of a woman’s life resembled ill health. Janet Oppenheim traces the foundation of this belief to a “theoretical merger of the female nervous and reproductive systems” in medical thought (181). In her words, “Nerves, ovaries, and uterus bound women in a stranglehold of sickness, unlike anything that men had experienced” (187). Not surprisingly, this “biology is destiny” argument had a far-reaching influence on attitudes about women’s capacity for physical and intellectual work and, by extension, on attitudes about invalidism in women. A man exhausted by “brain work” simply had to replenish his nervous energy; a woman faced “the arrest of the ovarian and uterine functions” (Oppenheim 194). Medical literature warned that women brazen enough to compete with men in the intellectual marketplace were likely to be rendered invalid by their determination and consequently were subject to moral censure on more than one count. Yet also in circulation was a counterargument

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that cautioned women about not exercising their brains. Conflicting cultural messages about intellectual work and health are registered in narratives by younger women invalids, as in the diary entries of Emily Shore. On 20 October 1836, for example, she wrote, “After, I am sorry to say, a very idle week, I resolved to begin studying again. I took up Morgan’s ‘Arithmetic,’ and read over carefully some of the earlier part. But I find my brain muddy and rusty with disuse during my long illness, and I was quite fatigued in a very short time” (165–66). Janet Oppenheim summarizes well the paradoxical situation that medical theory created for middle-class women: “They were told that they could become ill through idleness, but they faced equally certain punishment, in the form of nervous collapse, if they denied the natural differences between the sexes and attempted to compete with men. Breakdown from overwork was not a socially excusable failure in a woman, but loomed rather as a kind of retribution for ignoring both her reproductive duties and her responsibility to help, not rival, the men in her life” (200 –201). Thus middle-class women faced with extended illness received conflicting cultural messages comparable to those directed to their male counterparts but with different, perhaps higher, stakes. Studying the symbolic significance of the figure of the invalid woman, Diane Price Herndl presents a compelling argument that she “at once unites the romantic ideology of woman as ‘body’ (as opposed to man as ‘mind’), the Victorian stereotype of woman as weak and delicate, and the bourgeois ideal of woman as ‘conspicuous consumer’ (who passively consumes since as invalid she must be served at all times)” (10). The examples of the male overworked into his invalidism and of the female bedridden because she depleted her nervous resources on intellectual endeavors illustrate just some of the ways that medical discourse drew on domestic ideology to shape attitudes about work and in turn to influence popular understanding of debility, its causes, and its treatment. In intriguing ways, though, the culture of invalidism existed outside the practice and understanding of medicine in the period. To better grasp the ways that nineteenth-century medical history inflects the culture of invalidism, we must address the influence of public health crises on social attitudes about medicine and disease as well as key transformations in the medical profession that changed the meaning and experience of being a patient. Many of the major public health problems as well as the interest in public health more generally are traceable to the industrialization, urbanization, and population growth of the early years of Victoria’s reign, which also resulted in new work standards and attitudes about work. Crowding, combined with inadequate housing, water supplies, sewage systems, and venti-

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lation, posed myriad hazards to public health. Reformers like Edwin Chadwick, responding to the devastation caused in the 1840s by the coincidence of smallpox, typhus, Asiatic cholera, and scarlet fever, made recommendations for sanitation designed to improve national health. Yet for much of the century professionalized medicine was notoriously unsuccessful in combating the most devastating epidemic diseases. Imprecise or erroneous medical understanding about whether disease was caused by a miasma emanating from filth or by contagion from contact with an infected source impeded the medical establishment’s effectiveness in responding to public health crises. Smallpox vaccination, compulsory at midcentury, was the lone successful medical measure in this regard. Cholera was perhaps the most devastating epidemic, with four outbreaks in Victorian Britain killing well over 100,000 people. The diseases, debilities, and death associated with public health crises in Victorian Britain inevitably influenced more general beliefs about suffering and daily life, not least because many ran their course and killed so rapidly. As Bruce Haley writes, “The progress of the illness in a cholera victim was a frightening spectacle: two or three days of a diarrhea which increased in intensity and became accompanied by a painful retching; thirst and dehydration; severe pain in the limbs, stomach, and abdominal muscles; a change in skin hue to a sort of bluish gray” (6). Tuberculosis lasted throughout the century, but it killed so slowly that it never was thought to constitute an epidemic. Invalidism, with its associations of gradual decline, long-term suffering, and endurance, had special meaning in a culture saturated with fear of diseases characterized by how quickly they could kill. As Charles Rosenberg writes, “Chronic, or ‘constitutional,’ illness plays a more fundamental social role (in both economic and intrapsychic terms) than the dramatic but episodic epidemics of infectious disease that have so influenced the historian’s perceptions of medicine” (xix). Although the histories of epidemic diseases and public health movements are relatively well known, the history of being sick remains, Roy Porter contends, “terra incognita” (“Introduction” 16). What is certain is that the crucial, if gradual and subtle, changes in the practice of medicine that occurred in late eighteenth- and nineteenth-century Britain altered the experience of being ill and the meaning of being a patient. Although most medical historians consider anything that predates the advent of bacteriology and antiseptic surgery in the 1870s to be “premodern,” medical education, the emergence of a scientific basis of medicine, and the organization of the profession began much earlier in the century to transform the practice of medicine and to alter doctor-patient relationships in

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ways significant to the culture of invalidism (D. Porter and R. Porter, Patient’s Progress 215n1). In some ways the rise of scientific medicine and the emergence of a profession of medicine seem to have conspired in their mutual emphasis on objectivity to diminish medical interest in the patient’s history. As standards and guidelines for “case taking” emerged in the beginning of the nineteenth century, patients exerted less control over the kinds of information they shared with their attending physicians, who were increasingly concerned with streamlining their records to include only the “facts” relevant to nosological diagnosis, as opposed to patients’ presumably more subjective sense of the course of their illnesses.15 The proliferation of invalid narratives that occurred concomitantly with this moment in medical history suggests that the sick and suffering may have looked to popular culture for avenues through which to tell the medical stories and health histories no longer perceived as necessary to modernizing medicine —or perhaps to tell their medical stories in a different way than that cultivated in the case-taking scenario. The “scientific revolution” in Victorian medicine can partially be attributed to formal medical schooling, which early in the century began to supplement or replace the more traditional practice of apprenticeship. By midcentury, teaching hospitals and residential colleges for medical students had been instituted, and more specialized subjects were added to the curriculum. Still, although the Medical Reform Act of 1858 established a General Medical Council to register and define the legal terms of medical practice and the Reform Act of 1886 consolidated licensing examinations, medical schooling in Britain remained for most of the period quite conservative. Describing science in the medical profession as “a product of the mid- to late nineteenth century,” W. F. Bynum concludes that “science did matter to doctors collectively, even if it could be neglected by them individually, and even if much of ordinary medical practice was untouched by it” (219). A changing role for the patient is implicated at many levels in the history of medicine as a profession. For the first half of the century, as before, a physician’s status depended not on his scientific prowess or professional connections but on the status of the families under his care. Roy Porter and Anne Digby, among many others, have documented the power that patients, 15. For an overview of the history of “case taking,” as distinct from “patient history,” see Julia Epstein’s Altered Conditions, 27–55. Although Epstein shows that “historically, the move has been away from an individually located and environmentally connected suffering human body to a suffering body that is increasingly open to interrogation by observation and technology and that is, therefore, increasingly instrumentalized and taxonomized” (52–53), she also notes that the idea of letting the patient “tell his story in his own words” was a standard feature of case taking by the 1890s (51).

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particularly those with wealth, exerted in the medical marketplace of Georgian and pre-Georgian England.16 It was not uncommon, for example, for patients to play one doctor off against another, nor was it uncommon for a patient to take the initiative and “self-physick.” Henry Matthews’s enormously popular Diary of an Invalid illustrates on numerous occasions the influence the patient wielded in initiating and directing the medical encounter, as when he writes: “Reached Rome to breakfast. Went to bed in a high fever. Summoned a Roman surgeon to open a vein, which he did very tolerably; but their practice is much more timid than our own, for as soon as he had taken a large thimbleful of blood, he was for binding up the arm again, and protested, in the most urgent manner, against the madness of my proceeding when he saw me determined to lose ten ounces” (212–13). Another important way that patients exerted their authority was in opting to self-treat with the “specifics” advertised in the papers and widely available at apothecary shops or to pursue other forms of alternative medicine. William Russell, author of An Invalid’s Twelve Years’ Experience in Search of Health, pays tribute to the restorative powers of “Morison’s pills,” but he includes the following confession: “I have been taking medicine every day with few exceptions for over twelve years, during which time I have tried nearly every remedy which I have noticed in the Papers” (xi). Although throughout the period patients and doctors alike bemoaned “the follies of the hypochondriac and the crying evils of quackery” (Confessions of a Hypochondriac 37), many invalids advised their fellow sufferers to consider for themselves the healing potential of alternative and homeopathic therapies. Urging the readers of “Confessions and Observations of a Water Patient” to consider the advantages of water therapy, Edward Bulwer-Lytton wrote: “You cannot expect a doctor of drugs to say other than that doctors of water are but quacks. Do not consult your doctor whether you shall try hydropathy, but find out some intelligent persons in whose shrewdness you can confide —who have been patients themselves at a hydropathic establishment” (14). Charles Reade’s It Is Never Too Late to Mend presents a similar take on hydropathy. In his novel, the “water doctor” called to diagnose the problems of a patient made worse by his physician’s overdrugging has this to say about his patient: “You were weak, therefore they gave you things to weaken you. You could not put as much nourishment as usual into your body, therefore they have been taking strength out. Lastly, the coats of your stomach were irritated by your disorder, so they have raked it like 16. See also N. D. Jewson’s “Medical knowledge,” which compares the Georgian relationship of patient to physician to that of political patron to client.

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blazes. This is the mill round of the old medicine; from irritation to inflammation, from inflammation to mortification and decease of the patient. Now, instead of irritating the irritated spot, suppose we try a little counterirritation” (230). Summarizing the role of a market-driven society in shaping the relationship between doctor and patient, Dorothy Porter and Roy Porter write in Patient’s Progress, “Georgian England seems to reveal relations between paying patients and their medical attendants built upon a rough-and-ready parity” (95). A significant, if indirect, consequence of the medical legislation of midcentury Victorian England in terms of patient status was to give to the profession a kind of “collective muscle power” (132) that in turn may have considerably lessened the physicians’ need to claim their status through relations with individual patients or their communities. Throughout the century, where a physician had been educated and whom he had studied under gradually came to displace the significance that had been attached to the notion of how wealthy and well connected were the families in his practice. As N. D. Jewson summarizes it, “The focal point of a career in medical innovation shifted away from the network of primary relationships with the sick toward a network of secondary relationships with other clinicians” (236). The rise of scientific medicine had an even more dramatic influence on the experience of being a patient. The lyric titled “Clinical” in William E. Henley’s In Hospital represents a chief physician moving rapidly between patients, “with his pupils / Flocking and whispering behind him.” The lyric closes with an unsettling image of the patient left behind in the diagnostic process: Now one can see. Case Number One Sits (rather pale) with his bedclothes Stripped up, and showing his foot (Alas for God’s Image!) Swaddled in wet, white lint Brilliantly hideous with red. (18)

As it became a more legitimate and lucrative part of the medical career, scientific research produced more informed understandings of bodily processes (Risse 65). For example, during the course of the nineteenth century, physicians came to regard chronic pain less as the sign of psychosomatic

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disorder or “mark of the malingerer” and instead “developed the idea of the ‘syndrome’” and deployed “intermediate explanatory categories such as neuralgia, spinal irritation, or functional disorder” (Porter, “Pain and Suffering” 1576). Physical examination, as opposed to conversation, became the centerpiece of the bedside encounter (D. Porter and R. Porter, Patient’s Progress 74). Diagnostic technologies were invented throughout the century that extended the “inspection” of the patient beyond simple appearances (Shorter, Bedside 83). Stethoscopes and various ophthalmology devices helped physicians localize the sources of pain. Quoting a physician’s comment in 1879 that “‘Medicine is after facts, it does not matter who is at the bedside, the sick person has become a thing,’” Guenter Risse concludes that “patients were now viewed as disease material, objects for experimentation to further the gathering of new knowledge” (66). His views echo those of N. D. Jewson, who in “The Disappearance of the Sick-Man from Medical Cosmology, 1770 –1870,” attributes to the changes in professional status and the “rise” of scientific study a transformation from bedside to hospital to laboratory medicine, with far-reaching consequences for the patient. Under this paradigm, over the course of one hundred years the medical perception of the sick man moves from “person” to “case” to “cell complex.” Describing the consultative relationship that existed in the era he calls “Bedside Medicine,” Jewson writes, “The sick-man’s subjective experience of his symptoms were the raw materials from which the pathological entities of medical theory were constructed. His perception of himself as a unique individual with specific personal problems of physical and mental health were reflected in the enormous variety of pathological conditions generated by the phenomenological nosology” (233). In the era of “hospital medicine,” the clinician’s focus on diagnosis and pathology came to override the patient’s interest in prognosis and therapy. As Jewson writes, “The special qualities of the individual case were swallowed up in vast statistical surveys. In short, the sick-man was no longer regarded as a singular synthesis of meaningful sensations” (“Disappearance” 235). In Jewson’s estimation, the applied science motivations of laboratory medicine further detached the medical investigator from the sick: “It enabled him to conceptualize the sick-man as a material thing to be analysed, and disease as a physico-chemical process to be explained according to the blind inexorable laws of natural science” (238).17 17. Jewson’s argument has inspired a good deal of debate among medical historians. Edward Shorter, for example, credits the modern medical man with an interest and excellence in history taking almost comparable to that of his traditional forebears. In Shorter’s schema, the modern physician’s use of clinical investigation shows more of an interest in his patient. If better at diagnosis, he is never-

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While invalid narratives clearly belong to this moment in medical history, the sheer variety in approaches to representing illness and the doctorpatient relationship makes it difficult to generalize about their role. Pointing out that “narratives of illness were the medium of exchange between early modern patients and doctors,” Mary E. Fissell argues that such narratives were made “utterly redundant” by the increase in medical autonomy that characterized professional medicine from the mid-eighteenth century onward (92, 93). It would be far too simplistic, of course, to claim that the sick and suffering reacted instantaneously and collectively to their perceived displacement within medical cosmology, racing forward to present their narratives of affliction to a press eager to challenge the inhumane authority of medicine. Histories of alternative medicines and therapies are replete with evidence that, far from feeling themselves displaced, many patients orchestrated the medical encounter so as to foreground their own control. In her study of mesmerism, for example, Alison Winter shows how “the medical world was temporarily up-ended as the patients, ostensibly passive in the grip of natural forces, took increasing control of the medical stage” (Mesmerized 105). And invalid narratives representing more traditional medical encounters reveal myriad ways that invalids construed their own significance or exerted control over the medical encounter. Of his doctor, A. B. Ward wrote, “His appetite for information on our case seems insatiable, and that particular case the most important in his book” (61). Pondering the issue from a more practical perspective was the anonymous author of Letters from a Sick Room, who wrote: Any exertion of mind is often feared by friends and even prohibited by physicians, when the body is weak; but after a few trials and a little experience I needed not such prohibitions, though I am usually conscientiously scrupulous in complying with the requests, and attending to the prescriptions of those whom I have employed to counsel and direct me. If I have no confidence in them I will not employ them; but it is certainly gross injustice to disregard their injunctions, for how can any change be ascribed to its right cause, unless all orders have been complied with? how can any different mode of treatment be decided upon, unless that already adopted has been faithfully tried? (20 –21)

theless poorly equipped to prescribe effective medications. More accepting of Jewson’s claims is Mary Fissell, who argues that while his model was founded on a study of “elite patients” and their “eagerto-please” doctors, the same paradigm, in modified form, could account for “doctors’ relationships with their more humble clients as well” (92–93).

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This author’s comments provide a realistic glimpse of a patient exerting a measure of control over the medical encounter while at the same time ceding a degree of authority to the physician. A similar representation of the give-and-take relationship characteristic of many nineteenth-century invalids and their caretakers can be found in Emily Shore’s diary notes from 15 December 1838: “Oh! I had longed to sit all night watching the increasing beauty of the heavens and the ocean. But I am an invalid. I had already extorted several permissions to remain a few minutes longer, and at last my petitions were no longer attended to. Mr. Houghton took me down from the poop. I went to the cabin and sat down to my journal” (294). It would be equally foolish to posit a medical universe of physicians enthralled by science and disengaged from their patient population. C. Allan Black’s Essay on Conduct of a Physician in a Sickroom, written in 1867 for his medical degree, is noteworthy in its deference to the patient’s feelings, needs, and desires. The “physician should enter the room of his patient with the feeling that he has a serious duty to perform,” Black wrote (2), admonishing his fellow physicians to “avoid egotism” and to remember that “the patient is the central object in the sickroom” (3). Black’s essay proceeds, however, to focus on the patient’s reliability. For example, he advocates good manners partially because they will best enable the physician “to get at the truth” (4). He later makes the point that “it is obvious that the objective symptoms are most worthy of reliance, because we can measure these for ourselves, and have one standard for all patients. But otherwise with the Subjective; since patients equally anxious to tell us the truth, will describe their sensations in very different terms, when we have reason to believe they are the same or nearly so” (12). Many invalids extolled their physicians’ virtues in terms that undercut the image of a medical establishment no longer concerned with patients as people. A. B. Ward paints just such a series of flattering physician portraits in “The Invalid’s World.” He describes “R” as “alive to the opinion of his patients,” and of “wiry, plucky, generous, steadfast little S” he writes, “We old chronics welcome him as we do daylight after a night of pain. We can unbosom ourselves completely, be as long and as prosy as we please” (61). Evidently sensitive to controversy over the role of the patient in scientific medicine, Ward goes on to justify the ways of physician to man: Just ask your doctor to give you a scientific diagnosis of your case. The high-sounding, mouth-filling titles will increase immeasurably your respect for your own viscera, notably if there is nothing but a rascally little Biliousness to blame and he calls it His Excellency, Gastro-duodenal Catarrh.

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So far from corporeal substance being degraded, it is dignified by proper nomenclature and plain explanations. Ignorance, superstition, distorted ideas run more risk of materialism than Science can. (62)

Ward’s “defense” of the medical interest in science is muted by a mocking tone that clearly places diagnostic authority in the patient who, in this instance, recognizes the truth of “a rascally little Biliousness” while indulging the doctor’s need to be “high-sounding.” While the diagnostic prowess of the physician increased markedly over the course of the century in ways that fundamentally altered medical interest in the patient’s own account of aches, pains, and bodily sensations, the therapeutic abilities of the medical establishment remained notoriously suspect. As Edward Shorter writes, “The essence of their ‘modernity’ was the doctors’ ability correctly to diagnose disease: not to cure it, but to recognize what it was the patient had” (Bedside 75). The anonymous author of the April 1894 tract Experiences of an Invalid, by One Who Cured Herself professed to have ventured forth into print in order to argue that “prevention is better than failure to cure” (3). Perhaps because doctors had so little success in curing, pain management became more highly valued, and the period witnessed an “anaesthetics revolution,” spearheaded by the introduction of nitrous oxide, chloroform, ether, and various narcotics (Porter, “Pain and Suffering” 1589). Thus, although their association with scientific study clearly brought to the profession of medicine a certain degree of status, physicians’ inability to treat many of the diseases that science enabled them to diagnose helped patients to keep the doctor-patient relationship in perspective. Perhaps most important, even though nineteenth-century patients may have felt diminished as persons in the eyes of their physicians, the increased scientific attention to their internal sensations seems likely to have legitimized selfscrutiny of their aches and pains. Such a message is clearly part of the subtext to A. B. Ward’s sardonic claim that scientific language will “increase immeasurably your respect for your own viscera” (“Invalid’s World” 62). As early as 1844, Harriet Martineau found herself reveling in a subjective experience of sensation and pain posited as attainable only in the immediate. “Sensations are unimaginable to those who are most familiar with them,” she wrote. “Their concomitants may be remembered, and so vividly conceived of, as to excite emotions at a future time: but the sensations themselves cannot be conceived of when absent” (Life in the Sick-Room 27). Tracing through the century an “expansion of the symptom pyramid to include lesser and lesser complaints,” Edward Shorter distinguishes be-

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tween the traditional and modern patient in a paradigm that parallels that of the professional transformation from bedside to hospital medicine. He makes a persuasive case for viewing the traditional patient as both less sensitive to pain and less inclined to seek medical consultation (Bedside 57). In other words, modern medicine had its own version of Hacking’s “Making Up People.” Anne Digby has shown both how deeply the income of medical men influenced the types of persons recruited to the profession and how the range of medical fees exacted determined the patients who sought out their services. Modern medicine created, in Shorter’s words, “new kinds of patients” (Bedside 114) characterized by their “greater sensitivity to internal well being” (120). The proliferation of diagnostic categories in the nineteenth century engendered new sets of clinical entities that encouraged this process of patient making and, in turn, influenced how patients felt about themselves and how society felt about them. The explosion of taxonomies of the pathological extended, moreover, from categories of bodily disease to mental disorder. “In the same years that saw the heyday of mesmerism,” Alison Winter writes, “Victorians invented a host of new enterprises to examine and categorize the various modes of the human psyche” (Mesmerized 12). To the extent that many Victorian invalids were deemed incurable and hence beyond the reach of medicine, they must be regarded as very particular kinds of patients. Invalid narratives evince in a range of ways the independence of the author from the medical community and market. “While journalizing my daily experiences, I did not deem it necessary to make the Doctor, in any degree, the depository of my secret,” confided Richard Lane to readers of Life at the Water Cure (vi). The commonplace books often written by Christian invalids reveal the displacement of the medical community in another way; in these texts, the figure of the doctor is displaced by that of the minister, and suffering is attributed not to bodily disease but to sin. Still other invalid narratives are remarkable for how little they reveal about the illnesses or afflictions presumably responsible for their authors’ invalidism. Harriet Martineau’s Life in the Sick-Room makes little if any overt reference to her contact with physicians or to the physical symptoms of her disorder. As these examples indicate, it is crucial to keep in mind distinctions between the patient role and the sick role, and Roy Porter offers a similar caveat when he notes that the word “patient” may be historically misleading in its connotations of passivity (“Introduction” 3). “A sick-role may be claimed without seeking the aid of a doctor,” Anne Digby writes, and “whether sufferers decide to become patients and place themselves under regular practitioners was influenced historically by an evolving state of medical authority” (300).

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For this reason, Porter warns that “it is probably preferable to speak historically of ‘sufferers’ or ‘the sick,’ some of whom opted, in various ways, to put themselves into relations with medical practitioners—relations whose structure and dynamics need exploration” (“Introduction” 3). As the chapters that follow from this one will show, invalidism both instantiated and redressed the culture of suffering that characterizes the Victorian age. At this point it is simply important to see the figure of the invalid as belonging to this rather indeterminate culture of suffering as much as to particular moments in medical, religious, or economic history. The Evangelical revival, the emergence of a work ethic specific to an industrializing, urbanizing society, the concomitant spawning of new medical categories for disease and disorder, many of them gendered in nature, and the rise of professional medicine with new, purportedly scientific approaches to diagnosis and treatment and different models of doctor-patient relations all helped in very different ways to create a climate in which invalidism could flourish. Although far less concrete (and hence difficult to date) than these more tangible historical trends, a culture of suffering also helped make the climate conducive to invalidism. Exploring some of the ways that nineteenthcentury thought processed the meaning of suffering, Roy Porter writes, In the nineteenth century, the ubiquity of pain became a prime argument of atheists. Faced with the suffering involved in the struggle for survival, Charles Darwin and other sensitive souls could no longer accept that the wise person automatically looked, as Pope had recommended, “from Nature up to Nature’s God.” Christian evolutionists had their riposte: God had programmed the sanction of suffering into the evolutionary economy so that the weak would be weeded out, and none but progressive specimens survive and thrive. (Porter, “Pain and Suffering” 1586)

The culture of suffering that Porter describes is everywhere evident in nineteenth-century narrative, but it is perhaps nowhere better captured than in the autobiographical language that Dickens deploys in David Copperfield: “That I suffered in secret, and that I suffered exquisitely, no one ever knew but I. How much I suffered, it is, as I have said already, utterly beyond my power to tell” (150). Harriet Martineau’s preoccupation with the challenges of representing her own experience with pain and suffering compares to Dickens’s language in intriguing ways: “This pain, which I feel now as I write, I have felt innumerable times before; yet, accustomed as I am to entertain and manage it, the sensation itself is new every time; and a few hours

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hence I shall be as unable to represent it to myself as to the healthiest person in the house” (Life in the Sick-Room 27–28). The excessive preoccupation with and valuation of suffering characteristic of the period comes into focus when set against an equally trenchant societal preoccupation with spiritual and physical excellence. The development of physiology and physiological psychology gave the healthy body and healthy mind a “special conceptual prominence in nineteenth-century thought” (Haley 4). If, as Bruce Haley contends, the “Victorians used physical health as the model for a higher human excellence, a way of envisioning it” (253), it is equally true that they validated suffering not simply for its ennobling potential but also for its unique capacity to express the power of subjective experience. Although pre-Victorian, Charles Lamb captures something of this in his spirited (if slightly sardonic) proclamation, “How sickness enlarges the dimensions of a man’s self to himself! he is his own exclusive object” (“Convalescent” 267). Robert Louis Stevenson was one among many invalids to claim that extended illness revealed “the real knot of our identity, that central metropolis of self, of which alone we are immediately aware” (“Ordered South” 73). Representing the subjective experience of the sufferer was a tricky business, however, for the boundaries between the idealized sufferer and the martyr were not necessarily clear, and the potential charge of morbid selfconsciousness loomed large. Beginning his influential essay “Characteristics” with the pronouncement, “The healthy know not of their health, but only the sick,” Thomas Carlyle moves on to decry the self-consciousness that depletes vital energy, which he associates with individual as much as with national health: “Self-contemplation . . . is infallibly the symptom of disease” (72). Instead, “the sign of health is Unconsciousness. In our inward, as in our outward world, what is mechanical lies open to us: not what is dynamical and has vitality” (71). Charles Kingsley would repeat the formulation when he wrote that bodily health “makes one unconscious of one’s own body” (2: 232). If nineteenth-century invalids were faced with a range of representational challenges and with competing cultural messages about the healthiness of writing about ill health, they clearly rose to the challenge, inventing and adapting sick roles to fit their circumstances and finding in numerous narrative forms conventions to meet their representational and intellectual needs. The variety of genres receptive to invalidism testifies not just to the importability of suffering and subjectivity into narrative but also to the varied nature of those expressions. Whereas some invalids opted to take on the persona of the confessor, others appropriated the role of spiritual counselor.

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Some narratives organize themselves around the specific experiences of the patient-author, and others direct themselves instead to the perceived needs of the suffering reader, the invalid author’s supposed “companion in infirmity” (Martineau, Life in the Sick-Room 107). Organized around forms of invalid narrative as well as types of invalid persona, the chapters that follow illustrate both dramatic and subtle variations in authors’ attitudes toward the possibility, even desirability, of recovery or cure. Despite very different conceptions of audience, sense of purpose, and rhetorical strategies, these narratives have in common their status as firstperson narratives. This status is an important reminder of the position of the invalid’s narrative within literary history. Although dimensions of religious, economic, social, and medical history help to account for the creation of a market for the invalid’s story, it is still necessary to recognize that literary forms most often provided the means to convey those stories. Advice books, travel accounts, works of spiritual consolation and secular self-help, hymnals, prayer books, tracts, essays, and diaries were all receptive to the invalid’s story, but because of their very different generic conventions, assumptions about purpose, and expectations of the reader, each exerted its own influence on what kinds of information invalid authors chose to impart and on what sorts of self-representational strategies they deployed. That these very different forms were malleable enough to accommodate the invalid’s voice demonstrates the value nineteenth-century Britain accorded to the figure of the invalid. Noting that the nineteenth century witnessed the “harvest of personal experience writing that had been emerging since the seventeenth century,” Michael Mascuch contends that autobiographies helped to produce the concept of the individualist self (71).18 This argument suggests that we consider carefully the potential ability of the invalid’s autobiography, by virtue of its having worked its way into an array of literary forms, to reflect fundamental notions of identity. A connection between private spiritual confessionals and the emergence of an autonomous, interiorized self-identity may be, as Mascuch observes, a commonplace of scholarship, but nineteenth-century invalid narratives pose some undeniably important challenges to this model, not least because of their complex messages about the nature of privacy, the special kinds of interiority made possible by suffering, and the meaning of self-identity for the public figure of the invalid. 18. See also Gillian Brown’s provocative study Domestic Individualism: Imagining Self in Nineteenth-Century America, which studies the effect of an emergence of market society on conceptions of individualism, paying particular attention to a domesticity inflected by “values of interiority, privacy, and psychology” (1).

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Such issues are particularly crucial to confessional narratives, the subject of chapter 2. Often written by those considered hypochondriacs, these “nervous narratives,” to use Peter Logan’s label, reveal in intriguing ways how invalidism could collapse perceived boundaries between the secular and the spiritual, the masculine and the feminine, the medical and the social, and, more broadly, the fraudulent and the true.

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“BEYOND HOPE, HELP, OR REMEDY” Confession, Cure, and the Hypochondriac’s Narrative

The hypochondriac flatus is subsiding; the acres, which in imagination I had spread over—for the sick man swells in the sole contemplation of his single sufferings, till he becomes a Tityus to himself—are wasting to a span. —Charles Lamb, “The Convalescent” There is, let us confess it (and illness is the great confessional), a childish outspokenness in illness; things are said, truths blurted out, which the cautious respectability of health conceals. —Virginia Woolf, “On Being Ill”

C

onfessional texts expose especially well complexities in the relation between literary form, cultural history, and the invalid’s narrative. In the late eighteenth and early nineteenth centuries, medical understanding converged with developments in autobiographical writing and with Evangelicalism’s emphasis on selfexamination to help popularize the confessional form and to invest it with particular significance. Nineteenth-century confessional literature is distinctive in its foregrounding of public, professional identity (as revealed, for example, in titles such as Confessions of a Detective Policeman, Confessions of a Medium, The Confessions of a Scribbler, and Confessions of a West-End Usurer). Yet the confessional mode was premised on the expression of ostensibly private matters, and the nineteenth-century form’s mutual investment in public and private dimensions of identity made it seem a natural fit for invalids eager to disclose the social circumstances and somatic conditions that either 64

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had led them to become invalids or that characterized their experience of invalidism. This chapter explores the use that invalid authors made of the confessional mode and studies how its conventions aided their self-fashioning as particular kinds of patients. Bulwer-Lytton’s “Confessions and Observations of a Water Patient,” the anonymous Confessions of a Hypochondriac, and, much later in the century, John Addington Symonds’s Memoirs reveal a variety of ways that the confessional mode served especially well those invalids who believed the source of their debility was deeply rooted in Victorian ideologies of manhood, particularly those that linked sexual health to industry. To begin an inquiry into these issues, we might do well to examine rhetoric deployed in the opening pages of Confessions of a Hypochondriac, a work published by Saunders and Otley in 1849. Describing the symptoms that led him on a long and difficult journey of medical and personal discovery, the author wrote: I lived in a tremor of vague apprehensions, anticipating the evils of every hour, and feeling as if bespoke, and on the brink of death. The noises of Babylon appeared to be in my ears; a furnace of fire seemed to be consuming me within; and the perversion of every sense, and subversion of the will, made me pitiably incapable of persisting in any course for two hours together. I changed in everything, in every hallucination, except the delusion—that I was irrecoverably ill—ill, beyond hope, help, or remedy. (23)

This author was nothing if not dramatic. The account in its entirety, like this passage, is rife with a language of apprehension and tremor, of perverted sense and subverted will, the threat of consumption emanating not from without but from within.1 Seeking to evoke for his readers the acuteness of his sensations, he inadvertently reveals how his experiences and his text more generally are indebted to a culture of sensibility that like Evangelicalism—or at least alongside it—promoted an intense interiority, even investing it, as G. J. Barker-Benfield demonstrates, with “spiritual and moral values” (Culture of Sensibility, xvii). But at the same time, he indicates the gravity of his condition’s medical consequences, with his use of “perver-

1. Many invalid authors make use of the semantic connections between consumption defined as physical disease (tuberculosis), as the act of consuming, and as the use of goods in satisfying wants or in production. See Roy Porter’s “Addicted to Modernity: Nervousness in the Early Consumer Society.” Given the anxiety invalids expressed about the medical consequences of idleness, it is also interesting to consider the implications of Thorstein Veblen’s argument in The Theory of the Leisure Class that during the nineteenth century “conspicuous leisure” was ultimately replaced by “conspicuous consumption.”

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sion” and “subversion” suggesting the extent of his (or his culture’s) reaction against the self-scrutiny, wariness, and profoundly disturbing transformation believed to be embodied by the hypochondriac. Similar concerns had been expressed decades earlier in “The Convalescent” by Charles Lamb, who described being called back to activity and “the petty businesses of life” as “a wholesome weaning from that preposterous dream of self-absorption” and wrote of “the puffy state of sickness” in which he “confess[ed] to have lain so long, insensible to the magazines and monarchies of the world alike; to its laws and to its literature” (Essays of Elia 271). Lamb’s rhetoric of confession implies that shame attaches as much to his self-absorption as to his extended inactivity. The fear of bodily and psychic transformation—embodied in Lamb’s instance by the “puffy state” of the hypochondriac—seems only to have increased as the century progressed. Indeed, by the time the physician George Savage wrote an essay on “hypochondriasis” in 1892, he was able to maintain not simply that “the disposition of the [hypochondriac] patient slowly changes so that the kindly and unselfish man becomes selfish and egotistical” (611) but also to contend that “it is not uncommon to meet with patients who maintain that they are conscious of the circulation of their blood” (613). In attending so faithfully to his fluctuating sensations, the author of Confessions of a Hypochondriac exposes the very conditions that he desires (as the act of confession suggests) to atone for and to control, and his book, stressing as it does the involuntary aspects of his medical condition, announces its status as “symptomatic text.” 2 Yet whatever its pretense toward honest revelation of authentic symptoms, the work’s subtitle, The Adventures of a Hypochondriac in Search of Health, seems designed to situate it within a tradition of peripatetic fiction, a type of literature that readers would likely associate with early English novels masquerading as “true histories.” This mid-Victorian author’s rhetoric also plays on the affinities of his health account to that of a traveler. “I have resolved to leave a chart behind me,” he writes, “—not of the Irish coast or the Cape of Storms; a chart of the quicksands, breakers, whirlpools, false lights, and wreckes, I fell foul of in my voyage after health” (3). The author’s playful experimentation with literary conventions that hinge on assumptions of the true and the false, the known and the unknown, the safe and the threatening could not more effectively in-

2. In her discussion of Leslie Stephens and nineteenth-century discourses of autobiography, Laura Marcus notes the emphasis on the autobiographer’s seemingly unconscious urge to reveal confidences and secrets: “Autobiographies are symptomatic texts, through which, and beyond authorial volition, the secrets of human nature can be fathomed” (48).

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troduce the problems of his identity as a hypochondriac, or of his chosen mode of expression, the confession. By the time the author of Confessions of a Hypochondriac penned his work in 1849, the confession had become a well-known literary form of autobiography. Its conventions depended on a generic relation to diaries and letters, materials that traversed similar content but did so as authentically private documents. As Joan Lane writes, “A diary was above all else a repository of the writer’s secret hopes and fears, ambitions and disappointments, and in this category diarists included their medical problems, cures, unsuccessful or satisfactory treatments, opinions of medical practitioners and their advice, as well as, in some instances, how they felt towards the whole experience of death, of being ill themselves or of tending an indisposed member of their family, often during a period of many weeks” (208). Although the confession masqueraded as a repository of secrets, it also presupposed an audience of readers assumed to be similarly susceptible to the evils or ills the author confessed to. Dennis Foster has written that confession “seems clearly to be based on a model of communication, and yet it has been exploited by writers because it provides room for evasion” (2). Foster makes a point particularly relevant to invalid narratives adopting or adapting the mode; the value of confession, he notes, is determined not by “the presence of a secret content,” but by a “capacity for circulation and exchange” (14). Confessional literature raises additional issues relative to the roles accorded to the reader. As Susan Levin writes, “Placing the reader in the position of privileged confidant, the confessor can tell all. All texts ask for a reader, but romantic confessions articulate the very creation of the reader they need. Confession demands a listener. No longer speaking to God or the priest, the romantic confessional text creates a non-empirical ‘you’” (12– 13).3 The presumption of an audience through which one’s confession would circulate was both symbolic, a rhetorical feature attached to the confessional mode, and literal. De Quincey’s Confessions of an English Opium Eater created an enormous stir after the first part was published in the London Magazine; readers demanded more, the work was widely reviewed, imitations and parodies abounded, and the two-part magazine version was soon published in book form.4 Works such as De Quincey’s Confessions and James Hogg’s The 3. Oliver Buckton addresses the rhetorical and symbolic significance of the reader in confessional texts when he notes that the purpose of the narrative is “to strip the self of its protective secrets, ostensibly to satisfy the demands of an external listener or reader” (9). 4. For a more thorough discussion of the response to Confessions of an English Opium Eater, see chap. 8 of Grevel Lindop’s The Opium-Eater: A Life of Thomas De Quincey. See also Julian North’s essay “Autobiography as Self-Indulgence: De Quincey and His Reviewers.”

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Private Memoirs and Confessions of a Justified Sinner have stood the test of time well enough to occupy a space in most literary histories, but their first readers would have read them alongside many others—long-forgotten works such as Lamb’s essay “Confessions of a Drunkard,” E. F. J. Carrington’s Confessions of an Old Bachelor and Confessions of an Old Maid, and Anne Flinders’s Confessions of an Apostate. Indeed, the form remained viable throughout Victoria’s reign: Confessions of a Catholic Priest; Confessions of a Coward and Coquette; The Confessions of a Woman; and Confessions of an Old Smoker were all published in the latter half of the century, their titles reflecting the form’s interest in both public and private sides of identity. The periodical press supplied still more venues for confessional narrative, and sensational or playful articles such as “Confessions of a Toadstool Eater” were not uncommon in weekly and monthly magazines. Framing their narratives of ill health as confessions, invalid authors positioned them within this popular body of literature —one that capitalized as much on an association with criminal biographies and the fictional spinoffs as on its relation to the more reputable spiritual texts. The conventions of the latter had been established long before with Saint Augustine’s fifthcentury Confessions and extended through well-known seventeenth-century works such as Sir Thomas Browne’s Religio Medici and John Bunyan’s Grace Abounding.5 In essence, nineteenth-century invalid authors could appropriate confession’s associations with the criminal and scandalous to expose unsavory dimensions of their experiences—drug addiction, for example, or their own predisposition to malingering, or their willingness to indulge in quack medicine —yet simultaneously appeal to the form’s associations with the purifying potential of spiritual autobiography to endow an otherwise secular story of ill health with sacred value.6 Thus, although Oliver Buckton argues that confession’s status as a “religiously sanctioned form of oral discourse” was “later supplanted by the secular, written autobiography” (9) and Susan Levin calls attention to “a basic nineteenth-century shift in the autobiographical enterprise as the desire for personal identity replaces the need for religious absolution” (10), it is more accurate to say that nineteenth-century confessional literature capitalized on sacred and secular dimensions that functioned interactively 5. Susan Levin notes the “sudden increase in translations of the Confessions during the nineteenth century”: “In England, the same translations served from 1670 until 1807; then, seven new translations appeared in the three years from 1807 to 1810” (3). 6. Anti-Catholic attitudes ensured that such “sacred value” was not unproblematic, however. For some discussion of the traces of anti-Catholicism in representations of confession in literature of the period, see Elisabeth Jay’s Religion of the Heart, esp. 113–14.

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within narrative. Equally significant to confession’s popularity was its capacity to posture as an authentic representation of its author’s self-scrutiny that, however inward searching, simultaneously looked outward toward readers endowed with the symbolic capacity to render a verdict—that is, to incriminate or to absolve —or to share in and sympathize with the confessor’s sense of sin. The heritage provided authors a wide latitude for exploiting the truthful and fictional dimensions of their stories.7 The vexed issue of authenticity surfaces openly in Lamb’s essay “Confessions of a Drunkard,” originally published in the Philanthropist in 1813 and reprinted in the London Magazine seven years later. According to Lamb’s editor Homer Woodbridge, “A note prefixed to the essay in the London Magazine explains that the Quarterly Review had referred to it as a genuine confession. Lamb says that the portrait is an imaginary one of a ‘great Drinker,’ in which he made use of some experiences of his own and also of his ‘long observation of the effects of drinking upon all the world about him’” (Essays of Elia 428). The interplay between the truthful and the fictive that characterized the confessional form in its earliest “modern” manifestations may in fact have contributed to its appeal to men who, like BulwerLytton in “Confessions and Observations of a Water Patient,” felt they had to defend their use of “alternative” treatments or their support of fringe doctors whom many in the medical profession thought had duped their patients into either into believing themselves ill or believing themselves cured. For these reasons the confessional form appealed to a particular kind of invalid author, the hypochondriac, who suffered from an array of disorders very much akin to those of his more ancient counterpart, the melancholic man. In The Healthy Body and Victorian Culture, Bruce Haley makes the important point that while today we think of hypochondria as a disease of the mind, “in the nineteenth century it was a chronic disease of the whole person” (28). Vapors, dejection, irritability, withdrawal, insomnia or disturbed sleep, abnormalities of appetite, and headaches were just a few of the many symptoms thought to accompany and reveal hypochondriasis (Fischer-Homberg 392–93). Yet however associated with physically verifiable ailments, hypochondriasis inevitably raised questions of authenticity. Summarizing the skepticism toward the sick expressed by Adam Smith in his Theory of Moral Sentiments, Roy Porter and Dorothy Porter write: “Might not a devious person convincingly feign sickness, while being perfectly 7. In Anatomy of Criticism, Northrop Frye influentially credited Rousseau with establishing the “modern type” of a form that had been invented by Saint Augustine: “After Rousseau—in fact in Rousseau—the confession flows into the novel, and the mixture produces the fictional autobiography, the Kunstler-roman and kindred types” (307).

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healthy? Indeed—worse still—might not his imagination convince him that he was sick, despite A-1 health? The Georgians were haunted by the hypocrite who masked his true self. The malingerer and the hypochondriac both seemed varieties of that diabolical species” (In Sickness and in Health 189). The hypochondriac posed unique diagnostic challenges because of the role accorded in medical understanding to that inevitably amorphous entity, the imagination. Although hypochondria had long been defined as a “somatic abdominal disorder accompanied by a mystifying multiplicity of symptoms migrating around the body,” in the eighteenth century those symptoms came to occupy “stage centre,” and as “emphasis switched to the non-specific pains, and their relations to the ever-fecund imagination,” the hypochondriac “mutated into the malade imaginaire ” (R. Porter and D. Porter, In Sickness and in Health 203) (fig. 11).8 The line between imagined and real disease was further blurred by the fact that many of the remedies and treatments used to bring relief in fact “destroyed the stomach, producing serious side-effects” and triggering “further fears and medications” (206). Just as the figure of the hypochondriac epitomized self-indulgence, so too was hypochondria often “self-confessed,” a feature that helps to explain its association with confessional narratives in the nineteenth century. “Hypochondria was largely immune to the interventions of the doctors” (R. Porter and D. Porter, In Sickness and in Health 206)—hence its association with invalidism—and the reaction of the medical community to what, as the eighteenth-century progressed, seemed to reach epidemic proportions is revealing. Physicians scolded the hypochondriac public for their uneducated self-examinations, self-dosing, and obsessive talk of sickness, through which, the physician James Adair warned, “the imagination frequently suggests a similarity of disease, though none really exists” (qtd. in R. Porter and D. Porter, In Sickness and in Health 205). The self-confessed hypochondriac was threatening in part because he seemed to usurp from the medical establishment the power to diagnose and, in some instances, the means to treat. If the eighteenth-century manifestations of the hypochondriac elicited skepticism or even condemnation from the medical community, the nineteenth-century medical community—influenced by a growing body of literature in medical psychology—invested more sympathy and more sci8. For discussion of hypochondria’s significance to eighteenth-century culture, see R. Porter and D. Porter, In Sickness and in Health 203–10. They focus in particular on what kinds of behaviors the identity of hypochondriac authorized and situate its eighteenth-century manifestations within a broader context of medical consumerism.

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Figure 11. “Le malade imaginaire,” by A. Solomon. 1800s. Courtesy of the National Library of Medicine.

entific interest in the challenges that hypochondria posed to diagnosis and treatment. Proclaiming that “none of the faculties of the mind present phenomena so singular and so contradictory as the imagination” (53), J. Jobson wrote in the New Monthly Magazine that “a great portion of what are commonly called hypochondriac or hysteric attacks, and nervous complaints, originate solely in a diseased imagination. People are accustomed to laugh

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at such sufferings when they are known to proceed from this cause; but their mirth is exceedingly ill-timed. I know not, in truth, a more dreadful and more real disease, than that in which the essence of our being itself suffers; for it is ten times as easy to bear a real evil as an imaginary one” (53). These beliefs extended from the medical community into the lay population. The lengthy entry “Hypochondriasis” in the popular Penny Cyclopaedia published by the Society for the Diffusion of Useful Knowledge included the following remarks: The sufferings of hypochondriacs have been called imaginary, and, if it is meant that they are a product of the imagination, the appellation is just; but the appellation of “imaginary” is false if it is pretended that they are not really felt. Of all patients, those whose diseases are imaginary probably suffer the most. In many cases, however, these persons are affected with a real disease, and the term hypochondriasis is applicable to them only in consequence of their having their attention constantly fixed on their complaint, and of their experiencing a degree of fear and sadness which their condition does not warrant. (412)

Invalid authors took eager advantage of evidence that seemed to legitimize the seriousness of imaginary affliction. In “Confessions of a Drunkard,” Lamb wrote of the “uneasy sensations in head and stomach” that he found “so much worse to bear than any definite pains or aches” (Essays of Elia 372). In a similar vein, the author of Confessions of a Hypochondriac wrote, “It is harder, I am told, to cure an imaginary than a real disease,” and then launched into 300 pages worth of details about his search for that cure (23). Despite their formidable influence, sympathy and science could not protect hypochondriacs, however serious their sufferings, from occasional taunts. In Dickens’s one-act farce Mr. Nightingale’s Diary, the landlord of a hotel at a water spa observes that “of all the invalids that come down here the invalids that have nothing the matter with them are the hopeless cases” (156).9 Although he himself had testified to the benefits of hydropathy, Dickens could not resist poking a little fun at the tendency of hypochondriac patients to embrace new therapeutic treatments. Arriving at the spa, Mr. Nightingale describes himself as a “nervous man,” an invalid who has “not known a day’s health for these twenty years” (165), a phrase he repeats numerous times throughout the play. Dickens satirizes both the self9. In an 1851 performance of Mr. Nightingale’s Diary, the character of Lithers, landlord of the “Water Lily,” was played by Wilkie Collins.

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centeredness of the invalid (at one point, Mr. Nightingale remarks, “If you were as intimate with your own interior as I am with mine, your hair would stand on end” [161]) and the self-delusion of water patients in particular, as when Mr. Nightingale says, “I am a water patient, but I’ll pay for wine. You’ll be so good as to call the pump sherry at lunch, port at dinner, and brandy-and-water at night” (160). Even the self-confessed hypochondriac could resort to self-condemnation, as did Leigh Hunt when he wrote in his Autobiography, “And what was it that I suffered? and on what account? On no account. On none whatsoever, except my ridiculous super-abstinence, and my equally ridiculous avoidance of speaking about it. The very fact of having no cause whatsoever, was the thing that most frightened me” (1: 294). Like invalidism more generally, hypochondria existed before the nineteenth century but during that period took on particular meanings and assumed a special status. Characterizing hypochondriasis as “the eighteenthcentury’s version of the ancient ‘melancholy’ and the ancestor of modern ‘neurosis,’” G. J. Barker-Benfield points to a process of transformation with enormous implications for those who, in the nineteenth century, experienced symptoms associated with the condition (Culture of Sensibility 25).10 By the end of the century, when the eminent physician George Savage, who was superintendent of the Bethlem Royal Hospital, wrote an essay on hypochondriasis for Daniel Tuke’s Dictionary of Psychological Medicine, he observed with confidence that “most cases of hypochondriasis [were] related to insanity in one way or another” (611). Savage argued further that the condition could signal either “nervous dissolution” or “imperfect evolution.” Although still debating whether it was a functional or an organic disorder, the medical community had reached consensus sufficient to begin to isolate its “more special” forms: “head hypochondriasis,” hypochondriasis of the digestive tract, and “sexual hypochondriasis,” each with different subjects, characteristics, treatments, and prognoses. The relation between the real and the imagined was not the only feature of hypochondria to preoccupy nineteenth-century minds. Both within the medical community and in the lay public, much attention was paid to the kinds of people most susceptible to hypochondria and the professions most 10. The connection between eighteenth-century versions of hypochondria and modern neuroses is explored as well in Esther Fischer-Homberger’s “Hypochondriasis of the Eighteenth Century: Neurosis of the Present Century”: “Everything that goes into the making of modern neuroses can be found to an astonishing extent in the eighteenth century’s hypochondriasis—though of course psychosomatic and purely psychopathological signs were then not as clearly separated from each other as they are today, and though the nosographical attitude of the ancient doctors toward hypochondriasis is not found in many modern psychiatrists’ concept of neurosis” (392). Like G. J. BarkerBenfield, she places hypochondriasis on a continuum that begins with melancholy.

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conducive to it. “Young men of studious habits,” “medical students,” and “persons in the habit of reading medical books,” as well as all of those who experience “the want of occupation and exercise” were particularly susceptible, warned the Penny Cyclopaedia (412). Such pronouncements were easily appropriated in popular fiction. The Young Northern Traveler: Or, The Invalid Restored is typical; in this work, the protagonist Frederic Delman is described as paying such “sedulous attention to his studies” that he becomes “pale and thin,” and to save him from the “labour of thinking, for which in his present state he had not the strength required,” his physician requires that he “resign all study” (3). These and many similar works reveal the emerging association of hypochondria with gender-specific assumptions about the middle classes. Associating hypochondria with the bourgeois man and with acquisitive society, Roy Porter writes that “the culture required that the anxious self expressed itself, by conversion, in the idiom of physical malaise, and this, in turn, was to be assuaged not (as was traditional) through religion or philosophy, but therapeutically, via the consolations of medicine. The market promised ever more alluring medicines to soothe away the hypochondriac’s pains” (Health for Sale 42). Summarizing the middle-class “epidemic” of hypochondria in the “late Georgian years,” Peter Logan writes that it “reflected a new set of assumptions about the bodies of speculators, traders, and businessmen and their wives, daughters, and servants. As a consequence, nervous disorders such as hysteria became the leading category of illness, accounting for two-thirds of all disease, and the new middle-class nervous body was viewed with considerable alarm” (1). In the physician Thomas Trotter’s influential early-century text A View of the Nervous Temperament, Logan locates an explicit association between masculine, middle-class occupations and hypochondria; Trotter determined that bankers, vendors, and investors from the rising commercial and bureaucratic branches of the middle class constituted the majority of British hypochondriacs (Logan 19). Invalid narratives provide substantial evidence to support the association of hypochondria with masculine occupations. Before proclaiming his belief in the curative powers of Morison’s pills, the invalid William Russell, author of An Invalid’s Twelve Years’ Experience in Search of Health, explained his long years of suffering as the inevitable outcome of his brush with the urban business world: “At the age of fifteen I went to a house of business in the City. How far the confinement necessitated by such a life affected my health, I cannot say, but after three years I was again laid up with Rheumatism, which compelled my going home. . . . I found strolling about a farm much easier than working in a house of business” (x).

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In many of his essays, Charles Lamb similarly depicted the consequences to men’s health of life in the business world. In “Christ’s Hospital,” for example, he refers to himself as a “hypochondriac lad”; in “Confessions of a Drunkard,” he writes that business “wearies, affrights, [and] perplexes” him (Essays of Elia 372); and in “The Superannuated Man” he “confessed to” his “incapacity for business” by writing, “I had perpetually a dread of some crisis to which I should be found unequal. Besides my daylight servitude, I served over again all night in my sleep, and would awake with terrors of imaginary false entries, errors in my accounts and the like” (Essays of Elia 282). Neither William Russell’s conclusion nor Charles Lamb’s recurring conflation of the businessman with the hypochondriac is surprising when one considers the science and pseudoscience either might potentially have marshaled to support his beliefs. Articles such as Robson Roose’s “The Wear and Tear of London Life” characteristically treated the business world as a source and site of nervous disorder. Roose described “commercial life” as “incessant struggles to get on, trampling, crushing, elbowing, and treading on each other’s heels” in the name of industrial progress, his language eerily evocative of the animal men that haunt Christina Rossetti’s “Goblin Market” (206), published at roughly the same time. As early as 1831 Charles Turner Thackrah had written The Effects of Arts, Trades and Professions, and of Civic States and Habit of Living, on Health and Longevity, a work that analyzed the effect of various industrial occupations on men. Ruing the tendency of business men to “find, too late, that they have sacrificed the body to the mind,” Thackrah held forth on the necessity of exercise and fresh air to the sound mind essential to successful commerce, yet he warned of the capacity of capitalism to produce physical and mental evil. “Why do we think and toil?” he asked, only to respond, “To obtain wealth, and thus increase our means of happiness. But will wealth compensate for the evils which attend it? Its acquisition produces—will its possession remove functional or structural maladies? Will it banish those thousand nervous and hypochondriacal feelings which produce more misery than even organic disease?” (qtd. in Taylor and Shuttleworth 294). For Bulwer-Lytton, as for other invalid authors, the answer was a resounding No! In September 1845 the New Monthly Magazine featured as its leading essay a sixteen-page “Letter to the Editor” titled “Confessions and Observations of a Water Patient.” Although not identified by name on the title page, the “Letter” was signed by E. Bulwer-Lytton, who as a past editor of the magazine and a leading figure of London literary circles was something of a celebrity. Designed among other things to extol the virtues

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of hydropathy, Bulwer-Lytton’s essay attributes his physical collapse to overwork, details his experiences at Malvern and other hydropathic establishments, and pays tribute to the multitudinous benefits of water, described at various points as “the Hygeian fount” (10) and the “chrystal lymph” (16). He concludes his essay by encouraging his readers to establish “intimacy with Water”: “Not Undine in her virgin existence more sportive and bewitching, not Undine in her wedded state more tender and faithful than the Element of which she is the type” (16). Indeed, the strategies and rhetoric that surface throughout his text expose a reciprocal relation between early Victorian beliefs about masculinity and invalidism that helps to account for Bulwer-Lytton’s attraction to the confessional mode. “O Brothers, O Afflicted Ones”: Bulwer-Lytton’s Invalid Audience Susan Levin has written that for Romantic writers “confessions were often professions, or statements of allegiance to a system of belief ” (3), and it is clear that for Bulwer-Lytton the appeal of the confessional mode rested partly in its letting him formally profess an allegiance to hydropathy, a popular form of “nature therapy” that was nevertheless regarded with skepticism and made the object of satire in the press (fig. 12). His choice of the confessional mode gestures toward a recognition of hydropathy’s status as fringe medicine and his corollary status as a “fringe patient.” Nevertheless, Bulwer-Lytton was one of many well-known writers to try the water cure (Darwin, Tennyson, Carlyle, Ruskin, and Wilkie Collins, among others).11 By midcentury, there were twenty-four water-cure establishments in Britain and Ireland, and some, such as Malvern, had as many as six thousand visitors annually (Browne, “Spas and Sensibilities” 102–3). Connecting their popularity to the impact of the Lunatic Asylums Acts of 1828 and 1845, which imposed new restrictions on admission to rest homes as well as lunatic asylums, Janet Browne argues that hydropathic establishments appealed to a particular set of patients. “After Shaftesbury’s Asylum Bill, no one could enter a madhouse or asylum without being certified by at least two medical practitioners—a move intended to reduce the possibility of patients being falsely incarcerated but one which also removed all likelihood of voluntary admissions,” she explains. “It seems very probable that 11. For more on Tennyson’s experiences as a hypochondriac and on his experiments with hydropathy, see “Tottering on the Edge of Madness,” chap. 3 of Ann Colley’s Tennyson and Madness. For discussion of other well-known Victorians who attempted hydropathy, including Ruskin, see Bruce Haley’s Healthy Body and Victorian Culture.

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Figure 12. Hydropathy cartoon. This caricature features a man being given a steam bath that is going drastically wrong. The text reads: “Take care that you manage the apparatus properly.” Reproduced with permission of the Wellcome Library, London.

the water-cure, coming so soon after these major medical reforms, provided a ready substitute for patients seeking voluntary, institution-based medical help during which they could still call the shots” (“Spas and Sensibilities” 106). Her hypothesis helps to foreground the agency demonstrated by invalids who sought relief from nervous disorders through hydropathy. Considering the popularity of the water spas from another angle, Roy Porter contends that they lasted “at least until the era of modern scientific, professional medicine —because they satisfied a deep desire that the healing enterprise should proceed within frameworks essentially sociable in their nature, and suffused with symbolic cultural meanings” (“Medical History of Waters and Spas” xii). Another take on this idea can be found in the anonymous Occasional Poems. By an Invalid, which includes a poem titled “Invalid Recollections of Home” and subtitled “Malvern, 1813.” The invalid figure of this poem entertains herself through sleepless nights with “visions of [her] deserted home” (23). Jonah Horner, author of Instruction to the Invalid on the Nature of the Water Cure, represents in a different way the tendency of invalid authors to locate symbolic meaning in the water cure itself. Linking the cure to a “Divine blessing” (iii), he emphasizes its status as natural: “It becomes

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the most powerful aid to the self rectifying power of nature,” he wrote, and “by the identical means she uses in less degree, for the preservation of health” (xiii). Praising water as a “joyous playmate” and a “genial restorer and soft assuager” given by God to “all the children of nature,” “Confessions and Observations of a Water Patient” still more obviously corroborates the view that hydropathy satisfied a need for something that conventional medical treatment could not or did not provide. Bulwer-Lytton’s effusive tribute to hydropathy’s healing potential goes some way toward explaining why, of all the writing about the water cure, his work was so widely regarded as influential. In his preface to a pamphlet version of “Confessions and Observations of a Water Patient” that came out the year after its appearance in the New Monthly Magazine, Bulwer-Lytton refers to the letters he received from other water patients, testimonies that confirmed some of his own points (11–12).12 Dickens was one among many to credit Bulwer-Lytton’s text with encouraging his own experiment with hydropathy. Richard Lane, author of Life at the Water Cure: Or, A Month at Malvern, claimed to have been contemplating whether to go public with his own testimony to the water cure when Bulwer-Lytton’s essay appeared and confirmed his inclinations. “The sensation which has been awakened by this eloquent and forcible advocacy of the Water Cure, may well prepare the way for other workmen in the same field,” he gushed, his rhetoric subtly reflecting the perceived need to reconcile invalidism with masculine occupations (ix). The author of dozens of novels, pamphlets, plays, and social histories, Bulwer-Lytton had been known to the world not as an invalid but rather as an exemplar of “amazing industry” (Campbell 8). “Confessions and Observations of a Water Patient” shows the way he wanted readers to understand the nature of his disorder. “I do not say that when I first went to the watercure I was affected with any disease immediately menacing to life —I say only that I was in that prolonged and chronic state of ill health, which made life at best extremely precarious—I do not say that I had any malady which the faculty could pronounce incurable —I say only that the most eminent men of the faculty had failed to cure me” (9). The essay was something of a “coming out” document, a public gesture designed to announce and make widely known his identity as invalid. Thus, when he wrote that “all invalids know, perhaps, how difficult, under ordinary circumstances, is the alterna12. These letters, similar to ones described by Ellen Chadwick, the “Famous Manchester Invalid,” and by Harriet Martineau (discussed in chapters 4 and 5, respectively) provide limited evidence of the real (as opposed to constructed) readership of invalid narratives.

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tion of habits from bad to good” and that “the early rising, the walk before breakfast, so delicious in the feelings of freshness and vigour which they bestow upon the strong, often become punishments to the valetudinarian,” he rhetorically claims kinship with the type (4). His references to what “all invalids know,” like his implied identification as an example of a wellknown type (“the valetudinarian”), help to construct his confession’s implied readership. Written at roughly the same time that Bulwer-Lytton sought publicly to defend his crime fiction, “Confessions and Observations of a Water Patient” is a defense of a different kind, one designed to counter some of the charges put forth by both hydropathy’s opponents and its enthusiasts. The rhetoric of confession is deployed to lend credence to his claims and to verify his own common sense, as when he writes: “I have read and heard of chronic diseases of long standing cured permanently in a very few weeks. I candidly confess that I have seen one such” (8). A preface attached to a oneshilling pamphlet version of his New Monthly Magazine contribution indicates that he sought as well to defend himself against charges specific to the hypochondriac: I ought not to conclude this preface without some remarks, intended as a reply to such as have insinuated that I have built my eulogia of the waterspa cure upon “the fancied cures” of “imaginary ailments.” On the contrary, aware not only of the tendency in others to ascribe to the enthusiasm of one whose imagination may have been overcultivated, much of the wonders he names, but also of that tendency in ourselves to exaggerate the merit of what we gratefully approve, I have confined my observations entirely to the rigid circle of my own personal experience, and my own absolute eyewitness. (8–9)

Although some of Bulwer-Lytton’s contemporaries may first have read the work when it was reissued as a pamphlet, the essay’s dual purposes are best revealed when it is placed in its original periodical context. At the time “Confessions and Observations of a Water Patient” appeared, the New Monthly Magazine had recently been sold to Bulwer-Lytton’s friend William Harrison Ainsworth. Bulwer-Lytton found in the New Monthly Magazine an opportunity to construct two readerships—one specific to the journal’s editorial board and the other a wider, unspecified audience of the ailing, and he likened both rhetorically to brotherhoods. Bulwer-Lytton’s representation of a masculine collective is interesting in light of the substance of the article itself, which emphasizes in its open-

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ing pages the sense of incapacity that led him to experiment with hydropathy. Using a rhetoric of depletion, he seems to confront definitions of “manliness” conventional to his time, those that stressed independence, energy, and endurance. Yet, as Janet Oppenheim summarizes, “Ideals of manliness in the first half of the century are the most difficult to characterize in general terms. A complex merger of late Georgian and early Victorian beliefs produced, at one and the same time, a continuation of many late-eighteenthcentury assumptions and a reaction against them” ( 145). A similar argument is set forth in Herbert Sussman’s Victorian Masculinities, which stresses “their variousness, their contradictions, their instabilities, and their transformations” over the course of the century (12), and in work by Alex Tuss, who writes of the “bewildering and often contradictory discourse” produced by Victorian images of masculinity (43). Bulwer-Lytton’s stint as a water patient corresponds to the period Herbert Sussman identifies with the development of a “new masculine poetic for the industrial age” (Victorian Masculinities 1). For Bulwer-Lytton, invalidism was a statement about—a response to —the masculine ideal, and his preface to the pamphlet version of “Confessions and Observations of a Water Patient” suggests that he particularly concerned himself with English masculinity. “The sick man has seldom energy sufficient to contemplate a long journey to foreign lands—intercourse with strangers, consultations in an unfamiliar tongue,” he wrote. “For the water-cure to become popular in England, the shy English patient, of all men, must find it in his own land, or add exile to his other afflictions” (5). Bulwer-Lytton links his experiences to problems of masculinity early on in the narrative proper when he details his reasons for venturing to Malvern—widely known then as a “mecca for nervous patients”—to try the infamous water cure as advocated by the doctors James Wilson and James Manby Gully (Oppenheim 133) (fig. 13). While Thomas Hinde hypothesizes that Bulwer-Lytton chose Malvern so as to avoid Bath, where he might have encountered his wife, Rosina, from whom he had recently separated, Bulwer-Lytton’s text offers instead a far more general rationale for seeking respite. He blames his distress on a middle-class work ethic: “I have been a workman in my day. I began to write and to toil, and to win some kind of a name, which I had the ambition to improve, while yet more than a boy” (3). He concludes: “To a constitution naturally far from strong, I allowed no pause or respite. The wear and tear went on without intermission—the whirl of the wheel never ceased” (3). Bulwer-Lytton draws explicitly here on the rhetoric of the “wear and tear complaint” that circulated in popular books such as C. H. F. Routh’s On Overwork and Premature Mental Decay: Its

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Figure 13. “Dr. Wilson’s Water Cure Establishment.” Line engraving by Edward Goodall, after H. Lamb. Reproduced with permission of the Wellcome Library, London.

Treatment. Such texts warned of the consequences of overwork to both male and female constitutions, but masculinity and femininity were implicated in quite different ways. Janet Oppenheim, discussing the wear and tear complaint, maintains that overwork and financial stress were seen as “both plausible and acceptable” causes of nervous collapse among men that—at least in the 1830s and 1840s—would not necessarily have been thought to compromise one’s manliness (155). Bulwer-Lytton clearly wanted to blame his own ill health on the part of masculine ideology that encouraged young men to seek public recognition and that validated and rewarded ambition. His machine metaphors associate his journalistic drive with masculinity, just as the phrase “to write and to toil” equates his work with physical labor. Medicalized language becomes even more apparent when he describes himself as “thoroughly shattered” by his exhausting work routine, as well as by the therapies advocated by his physicians. For early Victorian readers exposed to or influenced by the nascent psychiatric branches of medicine, the term would undoubtedly have connoted familiar images of “broken health” associated with nervous col-

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lapse, exhaustion, and prostration, mental afflictions that by the end of the century would be associated with neurasthenia. The vogue for water therapy in the early nineteenth century was fed by theories of its purported effectiveness in treating nervous illness. Water spas like Bath had flourished well before the “epidemic” of nervous disorder erupted in the late eighteenth and early nineteenth centuries, but their clientele shifted from predominantly wealthy invalids who placed their faith in “the remedial effects of mineral water” to more middle-class patients, men and women who not only were curious to test the therapeutic potential of mineral and ordinary water but wanted to spare themselves “massive doses of drugs” (Oppenheim 135). Bulwer-Lytton wrote in the preface to his pamphlet, As these establishments have spread, as they have surmounted the first prejudices that assailed them, they have won their way, not empirically, by bought puffs and venal scribes nor by that lucky accident which has often made awhile, leech and specific, the inconsiderate rage —viz., the cure of some potentate, or prince, or reigning beauty—nor by the dictum of some recondite and fashionable authority, but by the stoutened limb and cheerful countenances of patients, chiefly, hitherto, drawn from the middle ranks of life, and returning home to desk and counter, the amaze of the native doctor, and the example to his impatient patients. (5–6)

Hydropathy held particular appeal for the hypochondriac because its efficacy was assumed to be greatest precisely in those “‘disorders over which it is allowed that medicine possesses scarcely any control’”—cases, Janet Oppenheim notes, “for which no specific cause can be assigned” (134). These factors seem to have played into Bulwer-Lytton’s experiments with hydropathy. Chancing upon several pamphlets describing the water cure, he claims to have realized that he had “scarcely lived through a day without leech or potion” (4 –5) and to have hastened to Malvern to obtain a new kind of treatment. In “Confessions and Observations of a Water Patient” he warns that “in all cases where the nervous exhaustion is great and of long standing, and is accompanied with obstinate hypochondria, hydropathy, if successful at all, is very slow in its benefits” (10). His claim that “it is not my intention . . . to detail the course I underwent” notwithstanding (5), the letter covers everything from the variety and daily regimen of water treatments used at Malvern to the ups and downs of his own recovery and his observations of other patients. The material that Bulwer-Lytton traverses in his text makes it all the more intriguing that it was positioned within the New Monthly Magazine as

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a letter to the editor. He invokes the “editor” as addressee not just in the opening subtitle of his contribution but also in self-reflexive moments throughout the text. At one point, for example, he writes, “Now that I am fairly on the ground, let us call to mind, Mr. Editor, the illustrious names which still overshadow it at once with melancholy and fame” (2); at another, “And now, Mr. Editor, I may be pardoned, I trust, if I illustrate by my own case the system, I commend to others” (3). Toward the letter’s end he writes, “I must bring my letter to a close. I meant to address it through you, Mr. Editor, chiefly to our brethren—the over-jaded sons of toil and letters—behind whom I see the warning shades of departed martyrs. But it is applicable to all who ail—to all who would not only cure a complaint, but strengthen a system and prolong a life” (14). The intended readership —real and symbolic—of Bulwer-Lytton’s “letter” is nowhere near as self-evident as he implies. He writes to Ainsworth and to the “post” of the editor more generally; he directs comments to the men operating “behind the scenes” of the monthly and to all who work as journalists; and he alludes to former New Monthly Magazine editors, those he grimly identifies as “departed martyrs” (14). Bulwer-Lytton didn’t mean quite “all,” however, as becomes increasingly clear as the letter proceeds. When, by essay’s end, he writes “O brothers, O afflicted ones, I bid you farewell” (16) and admonishes parents to “dip [their] young heroes in the spring, and hold them not back by the heel” (16), readers realize that the intended audience is a decidedly masculine one. Bulwer-Lytton’s reasons for constructing a brotherhood of readers emerge in the letter’s two-page preamble. Reminding readers that he once occupied the editorial position to which he now addresses his letter, Bulwer-Lytton writes, “I feel as if there were something ghostlike in my momentary return to my ancient haunts, no longer in the editorial robe and purple, but addressing a new chief, and in great part, a new assembly” (1). The ghost metaphor functions here not just to evoke his phantomlike return to old haunts but also to convey his hypochondriac status. The trope had been similarly used by Leigh Hunt to connect his own “fits of nervousness” to hypochondria: “I thought that if I had but a cause, the cause might have been removed or palliated; but to be haunted by a ghost that was not even ghostly, which was something I never saw, or could even imagine, this, I thought, was the most terrible thing that could befal me. I could see no end to the persecutions of an enemy, who was neither visible nor even existing!” (Autobiography 1: 294). And the author of Confessions of a Hypochondriac bemoaned the “phantoms of disease” that “haunted [him]” (114). Posturing as a phantom emissary of journalistic rejuvenation helped

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Bulwer-Lytton to convey his own sense of the bodily change that had occurred in the hiatus between his editorship and his letter. The “admonitory purpose” he aligned himself with was directed in part to the editorial board, past and present, whose bodily and psychic health he believed was at stake. “Your post has been filled by men, whose fate precludes the envy which their genius might excite,” he warned gloomily (1). “To us behind the scenes, to us who knew the men, how melancholy the contrast between the fresh and youthful intellect, the worn out and broken frame” (2). Bulwer-Lytton depicts the New Monthly Magazine editors as a bunch of “fallen men,” their passage from innocence to experience secured by their overcommitment to work and signified by their bodily decay. In the concern he alleges to feel toward those who have succeeded him, he reveals a paternal anxiety about their ability to withstand the turbulent market that highlights one of the ways Victorian men were implicated in a middle-class domestic ideal. As John Tosh has summarized it, “Men tended to take seriously the responsibility of reproducing masculinity in the next generation” (12). In “Confessions and Observations of a Water Patient,” Bulwer-Lytton adopted this paternal posture toward his journalistic colleagues even as he used his investigation of hydropathy’s potential to challenge masculine ideals. He attributes his colleagues’ decline in health not to physical labor but to mental stress. He looks at his fellow professionals, men who “think and labour,” and sees a “vast field of suffering” (2). He enunciates, if indirectly, a thesis proposed during his time by some medical authorities—that because of their devotion to the mental strain of intense intellectual labor, middleclass men were particularly susceptible to nervous complaints. Whereas women could believe their nervous disorders emanated mysteriously from reproductive organs over which they exerted little if any control, men were “architects of their own suffering, for they typically brought on nervous prostration through overwork” (Oppenheim 152). Urging on his readers a sense of responsibility for their distress, BulwerLytton asks his addressee, Ainsworth, How deal we (especially we, Mr. Editor, of the London world—we of the literary craft—we of the restless, striving brotherhood)—how deal we with the body? We carry it on with us, as a post-horse, from stage to stage —does it flag? no rest! give it ale of the spur. We begin to feel the frame break under us;—we administer a drug, gain a temporary relief, shift the disorder from one part of another—forget our ailments in our excitements, and when we pause at last, thoroughly shattered, with complaints grown chronic, diseases fastening to the organs, send for the doctors in good earnest. (2)

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Although he targets the medical community and the patients who rely too much on their services, he more specifically castigates ambitious journalists like those he has known. Characterizing the literary brotherhood as “a restless, striving” group, Bulwer-Lytton blames his competitive culture for emasculating its men, for preventing them from developing the physical strength, discipline, and firmness necessary to a healthy male identity. Bulwer-Lytton’s health history may have been invisible to readers, but his editorial role was not, and he clearly assumed that the New Monthly Magazine readers were familiar with the editorial history he alluded to.13 During his tenure as editor Bulwer-Lytton apparently succeeded in making the New Monthly Magazine more spirited in tone than it had been under the previous editors, and he claimed to have increased its circulation.14 The rhetoric surrounding his efforts is telling; the magazine itself was likened to a male patient and Bulwer-Lytton to its attending physician when a reviewer for the Rover credited him with curing the periodical of its “symptoms of exhaustion and decay”: “When Bulwer ascended the throne his restless spirit roused its slumbering powers and the New Monthly acquired the haughty stride of the political partisan in lieu of the mincing gait of a ‘waiting gentlewoman’” (“The New Monthly Magazine” 167). Bulwer-Lytton’s editorial achievement, such rhetoric suggests, was to masculinize the magazine. The implication is that when he found it impossible to sustain the effort and wrote that “it was my greatest literary mistake to attempt it,” 15 his comments extended to the ideologies of masculinity that undergirded his work as an editor. Accounts of the editorial transitions at the magazine during the 1830s show how far beliefs about energy inflected understanding of the editorial role. The editor was seen as the one responsible for ensuring that the periodical had the wherewithal to compete in a highly competitive market, and the ability to effectively marshal and manage energy was thought to be crucial to masculinity more generally. Energy,

13. Usurping the position from Samuel Hall, he took over the editorship of the magazine in November 1831, only to give up the post—which under Henry Colburn’s management went back to Hall—about two years later. As the introductory entry in the Wellesley Index would have it, “At this time he was a politician with a cause, and Colburn soon found he had taken on more than he could handle. Bulwer . . . turned the essentially apolitical, slightly Whiggish, literary journal into a vigorous radical organ shouting ‘Reform’ at the top of its lungs” (“The New Monthly Magazine” 166). 14. The Wellesley Index traces this claim to a memorandum of Bulwer’s attached to the Henry Colburn letters at the Hertford County Record Office (“New Monthly Magazine” 166). The circulation figures are debated; as Alvin Sullivan writes, “Depending on whose testimony one heeds, Bulwer’s politization of the New Monthly increased circulation, as he claimed, or decreased it, as Hall insisted” (335). 15. Quoted in “The New Monthly Magazine” 3:167.

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according to Ben Barker-Benfield, should be seen as “one of the most frequent and most characteristic terms associated with male activity in this period (along with its synonyms: vigor, vitality, vital powers, and vital forces)” (“Spermatic Economy” 338). Occupation and sexual identity were thus inextricably linked in the New Monthly Magazine. In rhetoric that would later permeate his “Confessions and Observations of a Water Patient” as well, Bulwer-Lytton concluded that his editorial experience had “exhausted him.” Even before Bulwer-Lytton wrote retrospectively of the exhaustion he associated with his editorship, he invoked similar rhetoric to describe the cultural milieu that surrounded his enterprise. His January 1832 number opened with the comment, “At this moment a certain weariness—a certain apathy pervades the higher classes of society. The little great world is sick of the eternal Reform, blasé with the cholera, and tired of the more novel horrors of the dissecting room and the Italian Boy” (qtd. in Sullivan 335). Although he intended to transform an apathetic readership into one more vital, the dismal social portrait paralleled his emerging self-assessment. When he left for Malvern, it would be because, like the society he bemoaned, he was “sick,” “blasé,” and “tired.” “Worn out and wasted,” he wrote, “the constitution seemed wholly inadequate to meet the demand” (3). He felt “morbidly restless and painful,” and “at morning . . . rose more weary than [he] laid down to rest” (3). The supply and demand metaphor invoked to explain his condition helps pave the way for subsequent discussion linking his physical collapse to an overly demanding work ethic. Tropes of expenditure and depletion further illustrate entrenched beliefs about the body’s economy, implying as he does a physical loss that leaves him spiritually or morally emptied. Bulwer-Lytton’s rhetoric here, like his references to restlessness and the expenditure of energy during sleep, might be seen to illustrate what Ben Barker-Benfield has called the “spermatic economy,” a term that highlights the significance of cultural anxieties attached to male sexuality and, he contends, the loss entailed in the ejaculation of sperm.16 The implication that his disorder threatens his masculinity resurfaces when, after warning his fellow journalists of the threat to their health, Bulwer-Lytton writes of his own decision to retreat from journalism and go

16. Janet Oppenheim persuasively cautions against overestimating the influence of a “spermatic economy” on male sexuality: “One cannot help wondering if economic considerations really did, in fact, flash through the ardent lover’s mind; just as medical advice to conserve nerve force was not likely to stop men from overworking, until it was too late, cautionary tales involving seminal loss probably had little significant impact on sexual behavior. Where they were influential was doubtless in their ability to induce guilt after the fact, particularly where an ‘unnatural’ act like masturbation was involved” (161).

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to Malvern: “I determined to have some insight into a knowledge I had never attained since manhood—the knowledge of health” (3). Malvern may have enabled him to acquire a kind of knowledge, but he nevertheless likens it to an Edenic event. Over and over he writes of his experience there as a passage from the fretful world of industry and ambition back to restful innocence. Revealing the confusion endemic to discourses of male sexuality more generally, he couches his representation of this innocent passage in highly charged language with erotic overtones, as when he notes the “utter innocence of the water-cure in skilful hands” and writes of his “rise from a sleep sound as childhood’s” and his “impatient rush into the open air, while the sun was fresh, and the birds first sang,” experiences that combine to convey a “sense of unwonted strength in every limb and nerve” (7). Appropriating the Faustian theme of assimilating nature’s resources to male powers (Barker-Benfield, “Spermatic Economy” 344), passages like these evidence just the desire for the symbolically evocative that helped to secure hydropathy’s success. Importantly, it is male experience that propels Bulwer-Lytton’s embrace of hydropathy’s supposed natural pleasures. “Patients accustomed for half a century to live hard and high, wine drinkers, spirit-bibbers, whom the regular physician has sought in vain to reduce to a pint of sherry, here voluntarily resign all strong potations,” he claims (6). The “all invalids” initially addressed in his appeal become, in a maneuver typical of the document as a whole, more specifically male: “Men to whom mental labour has been a necessary—who have existed on the excitement of the passions and the stir of the intellect—who have felt, these withdrawn, the prostration of the whole system—the lock to the wheel of the entire machine —return at once to the careless spirits of the boy in his first holiday”(6). Here, as at other points in the essay, Bulwer-Lytton attributes the success of his treatment to its capacity for rejuvenation; according to the logic of his claim, men who have allowed work to become a substitute for sexual pleasure must first be demasculinized by hydropathy’s processes so as to start afresh and be reeducated in pleasure as boys. Bulwer-Lytton’s description of his postimmersion experience nicely illustrates the sexual anxiety undergirding his endorsement of the water cure: “I emerged at last from these operations in no very portly condition. I was blanched and emaciated—washed out like a thrifty housewife’s gown— but neither the bleaching nor the loss of weight had in the least impaired my strength; on the contrary, all the muscles had grown as hard as iron, and I was become capable of great exercise” (8). However suggestive of the demasculinizing potential of hydropathy’s processes, the traffic of such pas-

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sages is toward the return of muscular and emotional strength. “The pure taste, the iron muscles, the exuberant spirits, the overflowing sense of life” are to be found in Malvern, he assured the New Monthly Magazine brotherhood (13). “Confessions and Observations of a Water Patient” becomes increasingly laden with the language of male sexuality as it progresses. As it does, Bulwer-Lytton’s motivations for couching his narrative as “confession” become more obvious. The passivity and prostration of the hydropathy patient are at points counterpoised to the arousal of water therapy. He writes, for example, “Here lies a great secret; water thus skillfully administered is in itself a wonderful excitement, it supplies the place of all others—it operates powerfully and rapidly upon the nerves, sometimes to calm them, sometimes to irritate, but always to occupy. Hence follows a consequence which all patients have remarked—the complete repose of the passions during the early stages of the cure; they seem asleep as if by enchantment” (6–7). Vindicating as he does the daydreaming and self-absorption that Victorians so often associated with masturbation, Bulwer-Lytton seems almost to sanitize “the solitary sin” by eliding the physical and spiritual dimensions of water’s cleansing properties. While the fact that the “all others” he refers to remain unnamed suggests their illicit status, the essay’s end makes clear that he feels as anxious about more legitimate heterosexual pleasure. In the penultimate paragraph, Bulwer-Lytton writes, “Here then, O brothers, O afflicted ones, I bid you farewell. I wish you one of the most blessed friendships man ever made — the familiar intimacy with Water. Not Undine in her virgin existence more sportive and bewitching, not Undine in her wedded state more tender and faithful than the Element of which she is the type. In health may you find it the joyous playmate, in sickness the genial restorer and soft assuager” (16). Domestic ideology seems to infuse the personification of water and the paean to Undine, the water nymph, yet his metaphors encourage readers away from the satisfactions of heterosexual union and toward solitary pleasure, symbolized by the vicarious union with water. The imagery and argument combine to corroborate Herbert Sussman’s claim that the “interior energy” that early Victorians used to define maleness was “consistently imagined or fantasized in a metaphorics of fluid” (Victorian Masculinities 10). The effusive language that characterizes the end of Bulwer-Lytton’s study of rejuvenation masks an anxiety evident through “Confessions and Observations of a Water Patient,” one that reflects contradictions embedded in notions of masculinity itself. Ultimately, Ainsworth may have best recog-

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nized the competing emotions at play in Bulwer-Lytton’s “letter.” He was said to be so grateful for the contribution that in return he presented his friend with “two suits of antique armor” (Hinde 215). Bulwer-Lytton had, in fact, invoked the metaphor of armor in the conclusion of the “letter.” Reminding his afflicted brothers that “health depends on healthful habits,” he exhorts them in conclusion to “become cased in armour against the vicissitudes of our changeful skies—to feel, and to shake off, light sleep as a blessed dew, let them, while the organs are yet sound, and the nerves yet unshattered, devote an autumn to the water-cure” (16). Symbolizing at once masculinity at its strongest and at its most besieged, armor is the perfect symbol of the water patient, passive and prostrate on the bed while wrapped in wet sheets but all the while regaining muscular and moral strength.17 Joseph Kestner has written that “if for the Greeks it was the naked male that constructed masculinity; for the Victorians it was the armoured male” (Masculinities 97). Quoting Joseph Kestner, Sussman argues further that fetishizing the armored male suggests “an occupation with the ‘potential for demasculinzation’ [sic]” (“Review” 582). Bulwer-Lytton’s water patient was a fragile being never fully cured and hence in need of that protective armor. “Confessions and Observations of a Water Patient” invokes a medical identity in order to expose ways that personal identity was compromised, even threatened, by ideologies of masculinity. Coming back to its sociohistorical context—its association with the period that Sussman aligns with the formation of a masculine poetic suitable for an industrial age —Bulwer-Lytton’s text might be said to be a last attempt to protect “the free expression of male emotions and the ready vibration of masculine nerves” that would soon be overtaken by an ideology of “robust physique” and “sporting manliness” associated with Kingsley, Hughes, and others (Oppenheim 147). Bulwer-Lytton’s achievement was to concretize this dimension of his argument by situating it within a more tangible critique of medical practice. Like many other hypochondriac invalids, he blamed the medical profession for its too ready recourse to drugs, and in the preface to the pamphlet version of his essay he attacks “the fatal absurdity of combating a chronic malady by strengthening its roots” (2). If, as Oliver Buckton contends, “the confession takes as its starting point the admission of sin, guilt, or some other form of error” (9), Bulwer-Lytton found in the association of water with innocence and hydropathy with natural 17. For discussion of the relation of the commercial world to the battlefield as reflected in cultural (and religious) beliefs about manliness, see Davidoff and Hall 112–13.

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pleasure an opportunity to transfer that sense of shame from patient to physician or, more specifically, to those in and around the medical community critical of establishments like those of Dr. Wilson and Dr. Gully. Bemoaning the tendency of traditional physicians to denounce hydropathy as dangerous, he wrote, “A little reflection taught me that the members of a learned profession are naturally the very persons least disposed to favour innovation upon the practices which custom and prescription have rendered sacred in their eyes” (5). He was not the only water patient to scold traditional physicians for their unwillingness to consider alternative treatments. In Life at the Water Cure, for example, Richard Lane blames the “hostility of the Medical Professors” (xiii) for his need to pay public tribute to hydropathy’s healing potential and to proclaim “the deep obligations” owed to the water cure (v). Well aware that hydropathy was a fringe operation even in its heyday, Bulwer-Lytton further cautioned his readers to be wary of whom they consulted in their attempt to find remedies for their aches and pains. “Do not consult your doctor whether you should try hydropathy, but find out some intelligent persons in whose shrewdness you can confide,” he wrote unabashedly (14). Clearly the physicians he refers to could no longer be naively considered the patient’s friendly confidants. No matter how prostrate and passive the water patient was while wrapped in his wet sheets, the patient that Bulwer-Lytton exhorted at essay’s end to “hold the doctor responsible for getting you out of what he gets you into” (14) was evidently far more capable of exerting control over his medical destiny than some Foucauldian interpretations of medical history would have us believe.18 If one of Bulwer-Lytton’s primary goals in “Confessions and Observations of a Water Patient” was to denounce the rigidity of orthodox medical men and, in doing so, to vindicate the healing potential of water doctors, another goal was to articulate the psychological health garnered through treatment. Roughly midway through the letter, he paused to reflect meditatively: For my own part, despite all my ailments, or whatever may have been my cares, I have ever found exquisite pleasure in that sense of being which is as it were the conscience, the mirror, of the soul. I have known hours of as much and as vivid happiness as perhaps can fall to the lot of man; but amongst all 18. Throughout “Shattered Nerves” Janet Oppenheim makes a strong case for reconsidering the idea that the nineteenth-century patient was prostrate before medical authority. For additional insight into patient power in the period, see Anne Digby’s Making a Medical Living: Doctors and Patients in the English Market for Medicine, 1720 –1911.

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my most brilliant recollections I can recall no periods of enjoyment at once more hilarious and serene than the hours spent on the lonely hills of Malvern —none in which nature was so thoroughly possessed and appreciated. (7)

Finding pleasure in his pain and arguing for the ontological awareness heightened through his invalidism, Bulwer-Lytton heroicizes himself as one who has found in hydropathy the means to triumph over not simply institutionalized medicine but also, more broadly, materialistic society at large — and thus to salvage a sense of manhood. It is in his tribute to the pleasure to be found in pain that BulwerLytton’s text is most similar to other types of invalid-written narrative. Writing that wet-sheet packing produced “the luxury of a profuse transpiration” that “changed pain into pleasure” (107), the author of Confessions of a Hypochondriac found numerous occasions to trumpet the theme, even though his work was devoted almost exclusively to exposing the claims of hydropathy as fraudulent and showing the hypochondriac to be a dupe. “One almost wishes [pain] to return to enjoy the delight of ease anew,” he later admitted. “The transitions from pain to pleasure are the sweetest moments of life” (269–70). But the motif was nevertheless problematic for hypochondriacs, primarily because they were —by virtue of their condition—subject to the accusation of having invented pain for pleasure’s sake. “Mind and body acted and re-acted on each other as if they were at enmity, warring for mutual destruction, warring in a life and death struggle, like two antagonisms, tormented and tormenting, in a perpetual war of malignity,” the author of Confessions of a Hypochondriac wrote in characteristically overcharged terms (295). Indeed, Richard Lane signaled his recovery from hypochondria by indicating, near the end of Life at the Water Cure, that he found imaginary pain painful: “For the past month real cares and griefs have been whistled off, and, for the time, left me untouched: to-day, the very whisper of an imaginary ill has power to build up a formidable and heartfelt infliction” (251). Hypochondriacs were doubly suspect, for the diseased mind that led them to imagine pains was equally likely to convince them that they had discovered cures. The author of Confessions of a Hypochondriac wrote scathingly of the figure whose “chase for a sufficient remedy is everlasting” and who “believes he has found the grand secret in every new disclosure” (194 –95). This interpretive bind posed by the hypochondriac’s investment in cure helps to explain the defensive tone and attention to evidence that characterize the narratives of hydropathic devotees such as Bulwer-Lytton and Richard Lane. In fact, the desire to expose the double bind of hypochondria seems in large

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part to have motivated the author of Confessions of a Hypochondriac to come forth with his own representation of the interpretive difficulties posed by hypochondria. “ Tormented and Tormenting”: The Double Bind of Hypochondria Confessions of a Hypochondriac is similar to the works of Bulwer-Lytton and Richard Lane in its indictment of orthodox medicine’s propensity to overdrug the patient. Near the beginning of his narrative, for example, the author writes, “For want of some constant affection to rouse and incite the feelings of our nature, I grew sick and ill. I hastened to Liverpool, and consulted my doctor, in spite of whose drugging and dieting I became nervous and debilitated” (20 –21). But rather than resorting to a “more sinned against than sinning” view of the patient, this text goes on to address myriad ways that alternative medicine abets the hypochondriac’s tendency to perpetuate his own medical problems. In doing so it represents a kind of diagnostic stasis, brought on by a vicious interpretive cycle maintained equally by the hypochondriac and the community of empirics, quacks, and physicians he surrounds himself with. In this view, invalidism is as much a function or product of stasis as a condition experienced as inertia. “If restored by some novel elixir today,” he observes, “it was to find my malaise with me tomorrow” (297). Writing at one point of his decision to travel from Malvern to Cheltenham to take advantage of “a great cure,” he notes: “Credulity has a celeritous promptitude; it never reasons, never stops till satisfied” (74). Yet it is a satisfaction always promised, never grasped. In fact, as he acknowledges, the satisfaction is only in the promise, the pursuit: Every hypochondriac will go the round of the watering places at home and abroad, and if he have a full purse and a warm imagination, he will also consult every physician of eminence and every empiric, and with the zest of a zealot try experimentally every new cure-all remedy, or mode, which the wit and wisdom of the wise and the sick have cunningly devised for the public’s good and their own. He consumes time chasing a phantom; if discovered it spoils his sport or cures his folly. (121–22)

Faintly echoed here, as in “Confessions and Observations of a Water Patient,” is language borrowed from the medical profession, which had in late Georgian and early Victorian England argued for the debilitating effects of the drive for consumption fed by an increase of luxury items. As Roy Porter

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describes the process, “Frankenstein-like, the consumer society was giving birth to a new personality type: man the consumer, pained by deprivation and craving commodities. He thus grew addicted to ‘consumption’; it was his disease” (Health for Sale 43). The shift Porter describes makes itself evident in the way various hypochondriac invalids interpreted their sick role. Whereas Bulwer-Lytton used tropes of consumption to represent threats to the male body posed by the industrial work ethic, the author of Confessions of a Hypochondriac figures the hypochondriac himself as a ravenous consumer, the victim of his own insatiable desires and of a public ever willing to use that desire to its own advantage. At another point the author complains that he “seemed to have consumed every novelty, for [he] knew all the modes, all the dishes of the dietary and Hygienic, all the odd sensations, comforts, and discomforts, of all the baths, bathings, and rubbings . . . of the establishment” (113). The motif surfaces again much later in the narrative when he describes his reaction to an exotic elixir: “Was I passing through purgatory into Paradise? I felt as if on fire; as if consuming or charring into a huge mass of charcoal” (212). Although the possibility of transformation tantalizes, the hypochondriac is nevertheless forever doomed to stasis. Confessions of a Hypochondriac links the inertia embodied by the hypochondriac’s doomed pursuit of health to a more all-encompassing cultural malaise —that of doubt. Throughout his narrative, the author invokes a rhetoric associated with a spiritual economy of faith and doubt. “Every change in my state, improvement or relapse, had been merely a transition from hope to fear, and from fear to hope,” he concludes. “Doubt had held the helm, therefore care was at the prow” (297). Picking up on the motif of the vicious cycle at another point in the narrative, he writes, “It was my fate, always hoping, to be always deceived. I had been drugged, pantomimed, placed in a bed, fed, starved, watered, bathed, shampooed, washed, curried, bolused, pilled, draughted, sweated, and vomited, and all to no purpose. What a predicament! Uncured, and yet pronounced curable by all!” (284). The passage illustrates the interplay between patient and physician at the heart of this author’s critique —one served well, he contends, by the confessional mode. Explaining much earlier in the text that his goal was “to expose the follies of the hypochondriac and the crying evils of quackery,” the author seeks to “relate such things as may tend to reveal the secrets of the one or the other” (37). While he blames his society for not agitating against quackery with the same vehemence that characterizes other efforts at reform, he identifies greed as that most responsible for sustaining a culture of

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duplicity. “The chronically ill are the certain prey of the empiric,” he writes. “He has only to whisper a promissory hope into the ear, and sooner or later, they are destined to be his victims; dupes immolated at the merciless altar of selfishness” (57). Acknowledging that quack medicines are more affordable than physicians’ fees, he warns his readers that “it is a false economy and a vicious infirmity which prompts us to purchase cheap ware, and shut our eyes to the fraud of cracks and flaws” (67). Such passages illustrate important dimensions of the indictment underwriting Confessions of a Hypochondriac. Not only does the author condemn quack medicine for its duplicity, but he denounces the hypochondriac for what amounts to intellectual laziness. The theme resurfaces in a different manifestation in the text’s many references to the specter of idleness. On the one hand, the author criticizes hydropathic establishments for catering to “a class of semi-sick idlers, more or less distinguished for birth, business, and money” (29). He writes later of the gossip that was “the fate of the sick and the occupation of the idlers of the community” (123). He returns to the theme in the conclusion to the book when remarking on the benefits to his health brought simply by returning to work and occupation: “It has convinced me that hypochondriacism is the affliction of idleness. Man was not made to do nothing, and he who spends and wastes his hours as if they were his own, not as if they were lent to him, probationally, has to pay for it with a proportionate misery” (306). Hypochondria, he argues, emerges out of and produces a person whose defining behavioral trait is an idleness at once physical and psychological. It becomes apparent very early on that the author has much to say about—and against—the medical endorsement of “rest.” Reporting that an eminent physician had told him that “too much work and the hurry and worry of trade had overstrained [his] nerves” and that he needed more rest, he retorts, “I had rested for months already, and yet, ‘with rest,’ I was to be restored!” (21).19 That other physicians evidently advised him “to resume his occupation of wares and merchandise” (20) only fuels his fire. As his experiences with this early version of the rest cure and with hydropathy evolve, however, this hypochondriac author becomes better equipped to self-diagnose. His analysis of his problems exposes the extent of the invalid’s own role in understanding and overcoming nervous disorder: “Mine was not a curable evil, or, so to speak, one which requires the 19. Confessions of a Hypochondriac was written several decades before the American neurologist Silas Weir Mitchell first began to trumpet the therapeutic virtues of the rest cure. For discussion of its importation to Great Britain through William Playfair in the 1880s and its identification with women patients, particularly those thought to be suffering from hysteria, see Oppenheim 181–232.

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agency of time, and oftentimes an entire life” (113). Idleness could be construed as a medical problem: “Impatience with waiting and fatigue grows from the seeds of vacuity, and my real weakness and want was mental employment” (113). Linking idleness with hypochondria, he writes, “To be ill was agreeable, for it held out the anticipation of getting well. Well and idle, I was miserable” (116). He also notes the tendency of the hypochondriac to delude himself with the promise of new remedies: “The evil remains, while the idleness endures.” Although positing his idleness as a medical complaint, he makes sure his readers understand its social implications: “I had that idleness which is as much the crime of the rich, as poverty is the crime of the poor. The one is starved by want, the other bored by inanity. Ennui is as killing to endure as hard work” (116). Although his status as a hypochondriac in some sense subsumes this author’s identity, he nevertheless finds in that status an opportunity to probe the ways that social status and the behavior associated with it have helped to make him who he is. Mockery characterizes the tone of the book, but its author makes a number of serious points about personal identity. Hypochondria, in his estimation, is less a condition associated with irritated nerves than one with a capacity to elucidate operations of the mind for the afflicted individual. “Often, as I felt I had mastered my disease, or was on the eve of doing so —the very success created a vacuum which reproduced it,” he notes at one point (114). At another point he argues that “the condition of the mind will produce or cure a disease, but its influence has hardly been appreciated” (157–58). The role of the mind is crucial not only in understanding the disease of hypochondria but also in characterizing the figure of the hypochondriac: “What is a hypochondriac if not one who has no faith in himself, nor, indeed, in any one else, for two hours together?” (109). Most significantly, he conveys the hypochondriac’s inertia by defining hypochondria as “a state of being without a sense of security; a perpetual suspense, an expectation, a dread of an inevitable evil” (109). In a reading of The Autobiography of Mark Rutherford, Bruce Haley similarly associates hypochondria with inertia; when Rutherford loses “all will to act,” Haley notes, his physician prescribes stimulants, which prove ineffective. For the author of Confessions of a Hypochondriac, the sense of inertia is intensified because it is aligned not just with the disease but also with its cures. Describing his daily “head bath,” he writes, “It was delightful while the indulgence lasted, and the idea of being cured was entertaining; but the day I was cured the mind lost the common centre around which it had gathered every thought and every feeling, and thrown on its own resources, having none, it revelled, like an idle schoolboy, in mischief, without mercy” (117).

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Confessions of a Hypochondriac uses, as the metaphor of the “idle schoolboy” suggests, a thematic of manhood to achieve resolution. Although not treated as thoroughly as in “Confessions and Observations of a Water Patient,” manhood is promoted as the recovered hypochondriac’s reward in much the same way as in Bulwer-Lytton’s text. Despite his excoriating treatment of the many empirics, quacks, and physicians who had led him astray, near the narrative’s end the author of Confessions of a Hypochondriac introduces “Dr. Goodly,” a semiallegorical savior figure who is associated with his childhood (and thus, by extension, with a return to innocence). Part of Dr. Goodly’s success rests in the fact that, rather than crediting the cure to his own medical prowess or to the power of drugs, he willingly transfers that power to the patient. “To cure is the end of physic,” he tells the hypochondriac, “and oftener than fancied, the cure is all in the patient’s hands, while the ill is in his appetites” (309). Although rhapsodized as godlike in his capacity to “give reason her empire once more” and create for this hypochondriac “a new world” (306), he is also a patriot keen to counsel his patients on the health to be found within the confines of their own country. Dr. Goodly advises him, for example: If you wish to travel, go for a ramble over the English coasts and counties, or the Welsh hills, where you have in miniature, a continent, and the relics of the barbaric and the civilized ages. The fresh breezes of our English vales and steeps are worth more, to the sick or the healthy, than all the washy waters of Germany, all the hashes of France. A stormy and fickle clime is a pickle which preserves beauty’s bloom and freshness longer, health and life in spite of our drinking habits longer, than richer and more constant climes. It has an evergreen influence; takes the seam from the brow, the track of toil from the cheek, and gives elasticity to the limbs. (302–3)

Exalting the invigorating and refreshing effects of “rural air and exercise,” Dr. Goodly convinces his patient of the therapeutic powers of nature that were similarly the key to Bulwer-Lytton’s supposed recovery. Spending “a season in his chosen retreat,” the hypochondriac is consequently transformed—“from darkness, distrust, and fretfulness, to light, confidence and content,—from feverish irritability, to relying fortitude” (300). Moreover, this natural therapy restores male potential, and just as Bulwer-Lytton had eroticized the pleasures to be had through hydropathy, the author of Confessions of a Hypochondriac pays closing tribute to the amatory propensities of nature: “I left London and its horde of Cossack charlatans, sick and sad, for the poison was within me; but nature, through her cheerful choristers,

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lovely blossoms, and matchless beauties, won me to be her lover—to return her salutations with noisy gladness. The apathy of age grew less, the elasticity of manhood returned” (296). The rhetoric of elasticity here takes on special sexual valence; yet it is not nature alone that restores man’s capacity to perform, but also Dr. Goodly’s sage counsel for the hypochondriac to seek “a direction, occupation, pursuit” (298). Threats to manhood were as much a concern to this author as they were to Bulwer-Lytton, although the two differed in their beliefs about just where —or how—the threat originated. For the author of Confessions of a Hypochondriac, the man who “spends and wastes his hours” in the idleness of an exhaustive and exhausting search for health is doomed to a failure figured as disbursement and expenditure —the invalid as a consumer consumed by his insatiable appetite. Thus his parting image is of a man restored to health, living happily and modestly on “a small farm in the west of England,” which he lets “in allotments to the labourer and artisan,” with little concern for tangible profit (309). Much as Bulwer-Lytton’s water patient finds in the spa a home away from the alienating marketplace, so too does this hypochondriac evidently need to disengage from, even renounce, capitalist pursuits to achieve health. His is a “regulated desire” more appropriate to healthy manhood (Sussman, Victorian Masculinities 72). Health, in turn, has produced a spiritual (and intriguingly feminized) vision that inverts the formula of hypochondriac consumption: “Generosity grows by what it feeds on—the milk of human kindness,” he preaches in conclusion (309). Despite their important differences, “Confessions and Observations of a Water Patient,” Life at the Water Cure: Or, A Month at Malvern, and Confessions of a Hypochondriac rely on remarkably similar views of middle-class male anxiety. Most overtly threatening to good health is the workplace, associated as it is with demanding and ultimately debilitating expectations of performance. Made ill by overwork, or otherwise inclined to nervous disorder, the male could all too easily become a hypochondriac and in doing so sacrifice rational understanding to an unchecked imagination and selfcontrol to unrestrained desire. That each text was published in the 1840s suggests that their anxieties reflect and corroborate the “difficulty of forming a new model of manhood in the industrial age” (Sussman, Victorian Masculinities 72). Yet the conception of manhood as an “unstable equilibrium” extended far later into the century (13), as John Addington Symonds’s Memoirs of 1892 reveal. The product of nearly eighteen months of steady effort, Symonds’s Memoirs explore many of the anxieties underlying earlier confessional texts—those having to do with performance in the public sphere, sources of

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energy and causes of depletion, the troubled passage from boyhood innocence to manly experience, and the tenuous relation between desire and selfcontrol. Yet in the Memoirs such anxieties are reexamined through the lens of psychological theories, particularly those having to do with memory, dreams, and sleep, that had not been so fully developed earlier in the century. Just as Peter Allan Dale has found in The Renaissance in Italy evidence of Symonds’s attempt to identify currents of a Renaissance type of mind, so too might we see the Memoirs as a study of a type of mind. Most key to Symonds’s study of his interiority are two interrelated currents, one determined by tensions between the healthy and the diseased and the other by tensions between the real and imagined. A “Deep and Unaccountable Malady ”: John Addington Symonds, Invalidism, and the Incurable Born in 1840 —the decade that would see the publication of “Confessions and Observations of a Water Patient,” Life at the Water Cure, and Confessions of a Hypochondriac —John Addington Symonds struggled with ill health for most of his fifty-two years. His Memoirs and letters make abundant reference to a childhood plagued by difficulties with sleep, problems with nerves, dramatic shifts in energy levels, and general sickliness—all conditions he felt were exacerbated by the pain of losing his mother or, on occasion, failing to live up to the standards set by his beloved and revered physician father. He seems to have assumed from the beginning that his troubled health originated in a combination of verifiable physical problems and nervous disorder, but this did not prevent him from suffering intense feelings of selfhatred, as the following passage so evocatively illustrates: “I was a very nervous child and subject to many physical ailments, which made me no doubt disagreeable to the people round me. It seems that I suffered from a gastric fever soon after my birth, and this left me weak—liable to recurrent attacks of diarrhoea and unretention of urine. Being sensitive to the point of suspiciousness, I imagined that I inspired repugnance in others; and my own condition not unfrequently made me noisome to myself ” (Memoirs 38). Symonds’s Memoirs document an adolescence and adulthood marked by everything from lung congestion, measles, boils, sties, colds, and fever to “wretched ennui and wild mental excitability,” fatigue, and “grave organic disorder.” At age twenty-five, and at a key moment in his academic career, he began to have the physical symptoms of consumption, the disease that would also destroy his sister and his daughter. The various physical and psychological debilities produced by or accompanying the onset of his con-

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sumption (e.g., weakness, fragility, excessive sensitivity, shame) were linked in his mind to those that he associated with work (and overwork) and with what he believed were the consequences of homosexuality. In essence, lung disease, an aborted academic career, and homosexuality converged either to render Symonds “invalid” or at least to provide him with the dispensation to adopt the identity. That the confessional form held particular appeal for him is not surprising, given the issues at play in his identity as an invalid. He had a longstanding interest in confessional literature, having read Saint Augustine’s Confessions nearly twenty-five years before he began his Memoirs. Considering Saint Augustine’s book “one of the most elevating and noblest” he ever read (Letters 1: 653), he studied the text closely, struggling to ascertain, among other things, whether its author was “a man of passion or of reflection” and asking, “What were his ruling passions?” (Letters 1: 453), questions that would frame his own self-examination many years later.20 Rousseau played as prominent a part in Symonds’s life; he evidently kept a copy of Rousseau’s Confessions by his bedside, and in 1863 he wrote: “I have often thought that, if I lived to do nothing else, I should write Confessions which would be better than Rousseau’s and not less interesting. I sometimes think that I am being trained for this” (qtd. in Grosskurth 33). Nevertheless, no matter how appreciative of Saint Augustine or Rousseau, Symonds’s letters reveal deep unease about self-revelation. In one of his last letters, written from Davos in February of 1893 to Robert Louis Stevenson, he declared: “My inner life, in these nine or ten years of our separation, has been the most eventful that I have gone through. But of this I cannot write. To write well from Davos to Upolu about burning points of experience is more than a sensitive soul can do. It is like screaming secrets to a vast void filled with listening unsympathetic ears” (Letters 3: 823). It is worth noting that Symonds’s anxiety stems not from the content of his “inner life,” posited here as “eventful” and psychologically thrilling, but rather from the toll that disclosure would take on a “sensitive soul”— the tax, in other words, for resorting to the confessional form. Even though he writes to Stevenson as “my dear old Friend,” he imagines here a far more threatening audience that voyeuristically hears but does not engage. Likening revelation of one’s inner life to “screaming secrets,” he suggests a

20. In a letter of 22 June 1866 Symonds reports that his friend Clementina Strong had bequeathed to him her copy of the Confessions, which contained many marginal notes recording her thoughts about the book. Symonds considered these notes to “form a sort of autobiography,” but he also pointed out that Strong “felt diffident” about “revealing what she felt deeply” (Letters 1: 653).

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profound skepticism of confession’s value. That this letter was evidently never sent confirms its relation to the confessional impulses of the Memoirs, which were written just a few years earlier but deliberately withheld from publication. Symonds adopts an “ex morte stance” in the Memoirs, Clinton Machann notes, “knowing that if it were published, publication would come long after his death” (“The Memoirs” 202). As Machann observes, the work “seems to represent an attempt to reach out to an as yet undefined audience of the future” (207), but much in the text suggests that Symonds wanted also to simply experience and serve his “truest self.” 21 Symonds chose as the only epigraph to the book a passage from Whitman’s “Inscriptions” in Leaves of Grass that includes the lines, “a few diffused faint clews and indirections / I seek for my own use to trace out here” (31). Still, he had more in mind than pure self-interest. His preface begins with the admission, “It would be difficult to say exactly why I have begun to write the memoirs of my very uneventful life” (29). Just a few paragraphs later he comments, “My object is known to myself. But it is not one I care to disclose in set phrases” (30). Asserting the control that he exerts over the content of his text, he emphasizes his choosing not to reveal his confessional motivations, a maneuver that helps to explain the seemingly lackadaisical quality of his claim that “someone, peradventure, will discover it” (31).22 The paradoxical quality of these prefatory comments helps to frame the text as a self-consciously problematic confession. On occasion Symonds makes explicit his autobiography’s status as such, as when he writes of the relationship he developed with Swiss peasants: “Entering thus into their lives, I have brought, as I confessed above, my passions with me” (268). Treating his emergent homosexuality as his “secret” life makes the confessional quality of the Memoirs more overt; describing his relationship with the chorister Willie Dyer, he writes, “I kept my love secret, and hugged the treasure jealously. It was the final flower of my long cherished inner self. Secrecy added charm to its romance” (106). The confessional impulses of the 21. I find especially compelling Machann’s point that Symonds’s sense of audience is “problematic at best for the works in which he has invested the most emotion and self-identity” (“The Memoirs” 207). As Machann notes, his homoerotic poetry remained unpublished, and only ten copies of A Problem in Greek Ethics, his history of pederasty in ancient Greece, were privately printed. 22. It is difficult to ascertain to what extent Symonds may have shared his work with close friends during its years of composition. Oliver Buckton writes, “He refers, in various letter to his close friends, to the fact that he was writing an autobiography, hinting darkly at the reasons why it would never be published. But there is no clear evidence that any of his friends, even those who knew he was homosexual, ever actually read the memoirs in their entirety” (231n45).

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text surface as well when Symonds confronts material he considers it painful to recollect. Of his wedding night, he writes, “I shall not forget the repulsion stirred in me by that Brighton bedroom or the disillusion caused by my first night of marriage. Disagreeable as it is, I cannot omit to tell the truth about these things, since they are all-important for the object I have in writing my memoirs” (156–57). The confessional mode clearly appealed to Symonds for distinctive reasons, and although his Memoirs functioned as a very different kind of text than confessions destined from the beginning for public consumption, it benefited just the same from the tradition’s investment in the purifying potential of coming to terms with acts of sin and sources of shame. Symonds adopted his invalid persona long before he commenced the Memoirs, and his understanding of the relation between his physical, sexual, and psychological health is key to his use of the confessional mode. Oliver Buckton attributes Symonds’s “departure from England as an invalid”—his phrasing nicely suggestive of the performative nature of the role —to a scandal that erupted at Oxford in 1862 involving a rival student, C. G. H. Shorting, and that threatened to make public his secret sexuality (95). Made more vulnerable by what his biographer Horatio Brown referred to as his “sensitive and febrile temperament,” and already strained by his academic pursuits, Symonds’s frayed nerves led to a complete collapse of health. In the Memoirs, he describes it as a “long month’s strain” that left him fragile and more susceptible to the “severe chills and rheumatism” that he caught on a visit to Belgium shortly after. He returned for another term at Magdalen, but he writes that “after three weeks my health failed suddenly; and I have never been a strong man since. Shorting indeed had his revenge” (133). Symonds emphasizes the consequences of this episode to his physical health, but he also seeks to evoke the psychological dimensions of his invalidism. Almost immediately after describing the encounter with Shorting, he writes in the Memoirs, “My illness declared itself one night in the form of a horrible dream; the motive of which was that I saw a weak old man being gradually bruised to death with clubs” (133). He recounts that he awoke “with the certainty that something serious had happened to [his] brain” (133), a diagnosis seemingly ratified by the weeks of bodily and mental suffering that followed: “I was like a creature which had been racked, and felt pain in every nerve and sinew. Of bodily suffering I had enough and to spare in the aching eyes and dull pain-shotten brain—never forgetful, that pain-burdened brain, waking or sleeping, of its deep unaccountable malady. The slumber of health became a boon remembered” (134).

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Echoing the kind of rhetoric used so effectively by the author of Confessions of a Hypochondriac, the passage exposes the correlation between Symonds’s identity as an invalid and a moment in the history of mind and medicine when the concepts of sleep and memory were studied to enable scientists to distinguish between normal and pathological mental functioning. The interplay of medical and psychological discourse in Symonds’s sense of himself as an invalid is most prominent in his representations of memory, dreams, and sleep. As avenues into his “inner life,” these three aspects of his existence became for him diagnostic tools, instruments that gave access from body to mind and enabled him to declare himself “incurable,” a stance (and sick role) in marked contrast to the recoveries mapped by BulwerLytton and the author of Confessions of a Hypochondriac. “Few people are contented with their memory, because all of us feel the inevitable limitations of a faculty on which we are continually making extraordinary demands,” Symonds writes in the Memoirs. “In my own case,” he continues, “I am certain that my memory was originally weak and unreliable. I remembered nothing definitely which I had not either seen or acutely felt.” Although he does not directly refer to himself as a hypochondriac, Symonds’s perspective corresponds to that of Thomas Beddoes, who had written in Hygeia that the hysteric and the hypochondriac share a belief that their memory has been compromised. Perhaps because Symonds “acutely felt” so much, his Memoirs belie his statement about the insufficiency of his memory, one of many confessions of inadequacy in a text that nevertheless documents in extraordinary detail connections he believed to exist between everyday experience and his social and psychological development. Symonds’s earliest writing shows the emergence of what would become a lifelong interest in the nature of memory and, via his association of this theme with pain, a connection to his beliefs about homosexuality and the invalid identity. The poem of 1861, “What Cannot Be,” has long been seen to reflect Symonds’s sexual discomfort in the years before he was, as one editor puts it, “galvanized by his reading into a kind of intellectual and spiritual coming out” (Fone 266). Beginning “Oh! what a pain is here!” the speaker proclaims: I yearned for pAll through the night I yearned for power, and nursed rebellious scorn, Striving against high heaven in hot despite Of feeble nerves and will by passion torn. I dreamed; and on the curtain of the gloom False memory drew an idyll of old hope,

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Singing a lullaby to mock my doom With love far off and joy beyond my scope. (Fone 270)

Representing doomed desire through his language of nerves, will, and passion, this opening stanza sets the terms by which Symonds continued, often in self-incriminating fashion, to assess his health, and it anticipates in particular a trope of “false shame” that punctuates the Memoirs. He connects his dream to “false memory” and blames both for beguiling him into the equally duplicitous promise of sexual satisfaction. If by the time he embarked on his Memoirs Symonds was more interested in vindicating his homosexuality than in incriminating himself, and if he was, as Linda Dowling has argued, committed to “advancing new modes of social identity” (13), he was nevertheless unable —even in a confessional work not intended for publication—to fully embrace as natural his “nature” (213), which he repeatedly associates with congenital moral disease. As Stephen Arata succinctly puts it, “Though at times he defiantly embraces this identity, Symonds habitually represents his ‘condition’ as abnormal and himself as an object of interest primarily to ‘the ethical psychologist’ and ‘the student of mental pathology’” (81–82). This understanding helps to account for Symonds’s sense of himself as an invalid. Central to the study of mental pathology in the latter half of the century, memory is the conceptual linchpin of Symonds’s efforts to come to terms with sexuality and health. The Memoirs move often from depictions of his feelings of fear and inadequacy to theories about memory: “Our earliest memories of words, poems, works of art,” Symonds writes, “have great value in the study of psychical development” (62). So pervasive as to defy summary, metacommentary about memory divides in his text into that construed as “normal” to human nature and psychological capacity and that which, pathologized in his understanding, was incorporated into the analysis of his sexuality. The language of memory that Symonds used to come to terms with his sexuality helps to reveal how this dimension of his identity became linked to his understanding of incapacity and invalidism. Reaffirming a belief that “the mere sharp recollection we retain of certain images is a sign of their potency” (62), Symonds writes in the Memoirs that “emotional states, whether painfully poignant or fragile in their evanescent lightness, I remember with unerring accuracy” (217). He struggled, however, with a recognition that his memory promoted homosexual desire by helping to perpetuate it and yet acted inadequately as a substitute for physical satisfaction. Of his attraction

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to one particular man he writes: “Passing stranger—you know not how I love you! The most toothed hubbed memories in my mind are evanescent romances of this sort” (qtd. in Norton 5). Perhaps not surprisingly, most of Symonds’s experiences of pain and poignancy were bound in his imagination to his homosexuality, and his sexual experiences with men became central to his understanding of memory itself. Reflecting on his earliest sexual encounter with a man, he writes, “The memory of this incident abode with me, and often rose to haunt my fancy” (187). Of his “ever-repressed longing” for another man, he concludes that “the tyranny had been overlived but still vibrated in memory” (123). In these and other episodes, Symonds analogizes the act of repressing desire to an operation of memory, a maneuver that enables him to account for the accuracy and endurance of the memory by associating it with physical and psychological pain. In doing so, he articulates a curious take on the popular notion that pain cannot be remembered, which Henry Maudsley, for one, had argued demonstrated memory’s organic nature. Although presented as casual observations, Symonds’s ideas indicate an understanding of consciousness that incorporated the prevailing view of the mind as a storehouse of latent impressions but also acknowledged that individuals reconstruct the events they believe they remember. In associating the power to recollect with the potency of the experience itself, Symonds made assumptions similar to those that W. C. Coupland would put in print only a few years later in an essay on the philosophy of mind for Tuke’s Dictionary. Declaring that “the intense privacy of memory is a delusion,” Coupland sought physical explanations for mental states. “Memory grows in accuracy” he asserted, “in proportion as external connections are increased” (37), and he explained that “why only some parts are remembered and not others is that the intensity is so variable” (36). Symonds’s language of haunted fancy is as suggestive as that of the painfully poignant and potent experience, for no matter how much he wanted to credit imagination with working reflectively to recreate memory, he more often depicts his own as “brooding,” “dangerous,” and “unhealthy” (78), going so far as to assert that “sins of the body are less pernicious than sins of the imagination” (127). Locating his “pathology” in the imagination, Symonds constructs homosexuality in language akin to that used by hypochondriac invalids to describe their chronic state of affliction. Sexual encounters also, however, prompt Symonds to resort to a language of aestheticism. The Memoirs document what he calls his “quest for ideal beauty.” Symonds wrote: “Incarnated in breathing male beings, or eternalized in everduring works of art, [it] was leading me to a precipice,

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from which no exit seemed possible except in suicide or what I then considered sin” (121). Advised by the surgeon T. Spencer Wells to marry as a way to cure his nervous debility, Symonds recollects his early relationship with Catherine North in a language replete with the tropes of the aesthetic: “I loved her ardently, and felt the thrill of something wonderful and new inrushing into my existence. But was it not too pure, too spiritual, too etherealized, this exquisite emotion? It would endure till death, I know. But I missed something in the music—the coarse and hard vibrations of sex, those exquisite agonies of contact, by which the God in man has subsumed into himself the beast and makes that God” (155). Aestheticizing his experiences clearly served Symonds at this crisis point. The “coarse and hard vibrations” echo both the physical sensations that David Hartley had argued in Observations on Man connected nerves with brain and the “laws of inheritance, the vibrations of long past acts” that Pater believed distinguish the modern man. Symonds’s letters show similar instances of this type of rhetoric. Writing to Horatio Brown about his dreams, he says, “My work has strung me up and your letters have stirred vibrations. But I believe that I have settled down into the jog-trot of work— mentally I know I have” (qtd. in H. Brown 149). The Memoirs suggest that Symonds came gradually to reject aestheticism as a source of sexual self-understanding and health. He likens aestheticism to a form of “false memory,” claiming that efforts to idealize his erotic instincts were subconscious attempts to “forget” and hence expel his homosexual nature and were doomed to failure.23 More important, he associates it with physical disintegration and invalidism. At Harrow and Oxford I was always on the verge of falling into invalidism. Irritable nerves and a morbid condition of the reproductive organs, due to the peculiar erethism of my sexual instinct and the absurd habit of antenuptial continence, rendered me physically a very poor creature. Then I continuously overworked myself . . . by the strain of emotions combined with my specific tendency to approach knowledge from the aesthetical and literary side. I lived in a perpetual simmer of intellectual and emotional fermentation. (230)

23. Much of the work done on memory by members of the medical establishment and those associated with the emerging fields of “psychical research” concerned itself with the pathological; indeed, Tuke’s Dictionary lists several entries for “disorders of memory,” but for “memory” itself he only cross-refers readers to Coupland’s “Philosophy of Mind” essay. Different forms of “false memory” in particular occupied thinkers as diverse as Forbes Winslow, E. S. Dallas, and Frances Power Cobbe.

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Complicating the claim that Oxford became the scene of Symonds’s “extraordinary intellectual and emotional liberation” (Dowling 77), the passage evokes an amalgam of physical and mental wrongs and shifts blame from self to society and back to self again—maneuvers that highlight the similarity of his Memoirs to the confessional literature of Bulwer-Lytton, Richard Lane, and the author of Confessions of a Hypochondriac. Through the lens of memory heterosexual convention and aesthetic approaches to knowledge are presented as parallel sources of undoing, as influential in Symonds’s downfall as the more conventional explanation of “overwork.” As Symonds had written of Harrow: “I thought that I had transcended crude sensuality through the aesthetic idealisation of erotic instincts. I did not know how fallacious that method of expelling nature is” (qtd. in Norton 3). The combination of wrongs helps not only to render Symonds an invalid but to let him associate the condition with stasis: “I lived in a perpetual simmer” (230). Although Rictor Norton claims that Symonds “became a healthy homosexual” (5), the Memoirs reveal a relentless anxiety and self-scrutiny that puts memory itself at the center of a vexed sense of health. In a letter to Henry Sidgwick, Symonds wrote, “My past life has been painful in many ways, and I bear in my body the marks of what I suffered. With you, with my wife, with friends like Arthur and Graham, or when I am writing verses, I can treat those troubles of memory with cheerfulness. But at times, when my nervous light burns low in solitude, when the fever of the brain and lung is on me, then the shadows of the past gather round, and I feel that life itself is darkened” (169). Symonds’s “painful” and “shadowed” past exists here in a mutually constitutive relationship with disorders of the nerves, brain, and lungs that also afflict him. He suggests that memory itself is a kind of heterosexual construct; it is represented as not just central but in fact analogous to his own troubled identity. Undercutting further any claims for text’s vision of “healthy homosexuality,” Symonds writes near the end of his memoirs: “And yet I carry within me the seeds of what I know to be an incurable malady—not merely the disease of the lungs, which is always ready to appear—but that more deeply rooted perversion of the sexual instincts” (281). Symonds presents himself as defined by a disease that situates him at the very boundary between present and future, awaiting an eruption of self construed as simultaneously inevitable and incurable. This is yet another way that he represents invalidism as a form of necessary stasis. In The Normal and the Pathological, the medical philosopher Georges Canguilhem contends that “life rises to the consciousness and science of itself only through maladaptation, failure and pain” (209). Pathologized as it was in his mind, memory proved uniquely capable

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of functioning as a cipher for Symonds’s experiences of “maladaptation, failure and pain.” Sleep —and the various mental states associated with sleep —served much the same function, and as with memory, the Memoirs pathologize it. The Memoirs relentlessly document problems with sleep that plagued Symonds throughout his life. “Sleep” was, in fact, one of the more extensive entries in Daniel Tuke’s massive end-of-the-century Dictionary of Psychological Medicine, and pathologies of sleep such as nightmares occupied the lion’s share of scientific interest. In his influential treatise of 1830, The Philosophy of Sleep, Robert Macnish had asked why “literary men, deep thinkers, and hypochondriacs [were] peculiarly subject to night-mare,” a question whose formulation reveals much about the assumptions brought to scientific investigation of the mind (102). Although Macnish would go on to claim that “the cause is obvious” and to locate the source of distress in “bad digestion,” many others did not share his certainty (102). Scientists of mental physiology throughout Victoria’s reign probed the relations between sleep, dreaming, and insanity for information about mental consciousness more generally. Symonds’s own father contributed to the field with an 1851 study titled Sleep and Dreams, which focused on the idea of double consciousness and differences between healthy and morbid states of mind. The study of mental disturbances during sleep, the loss of sleep as a cause and consequence of sexual dysfunction and insanity, and prolonged sleep were all deemed critical to medical psychology—and all contributed to Symonds’s understanding of himself as an invalid.24 Discussions of sleep and its pathologies were not the only way that the pre-Freudian community of medical psychologists debated mind, body, and sexual health. As scientific study of gynecological medicine developed, diagnoses such as “sexual hypochondriasis” gained credibility, and the figure of the “male hysteric” became distinguished from the somewhat more shadowy figure of the hypochondriac (Micale 199). Symonds himself visited Cheltenham and Malvern, though only briefly, and was at one time diagnosed with “hyperaesthesia,” a condition characterized by extreme physical sensitivity much like that associated with hypochondria and hysteria. Although he was particularly well read in case histories of “sexual inversion” and the literature of sexology, his thinking derived more broadly from work in psychology and medicine and the emergent field of psychiatric medicine. 24. As Herbert M. Schueller and Robert L. Peters summarize in their introduction to the Letters, Symonds “kept abreast of happenings in medicine and in psychology, and to the latter he made a real contribution, one fully told for the first time in these letters: Symonds stands out clearly as a pioneer sexual theorist” (Letters 1: 36).

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While such work sometimes provided him with the comfort of a purportedly scientific understanding of bodily and psychic sensation, it as often routed him toward a sense of his symptoms as unaccountable and his self as incurable. These, in turn, promoted an identification of himself as an invalid. Symonds understood both sleep and memory as physiological, but he comprehended sleep as part of a process that included the idea of awakening. This understanding in turn opened up different possibilities for selfunderstanding. Admitting early in the Memoirs that “dreams and visions exercised a . . . potent spell” and that “nigh to them lay madness and utter impotence of self-control,” Symonds openly associates anxieties about sleep with those of sexual identity (41). His anxieties reach fever pitch when, reflecting the influence of the body of scientific thinking that linked “spermatorrhea” to the external pressures that drained a man of his resources (and that rendered him subject to hypochondria), he associates “unrefreshing sleep” and “vivid” dreaming experienced in adolescence and early adulthood to “seminal losses” (122). The well-known physician James Paget, whose work Symonds almost certainly followed, had argued for spermatorrhea as a form of sexual hypochondriasis or male hysteria (Taylor and Shuttleworth 168).25 When viewed in these terms, Symonds’s kinship with Bulwer-Lytton and the author of Confessions of a Hypochondriac becomes more apparent. Symonds’s Memoirs are punctuated by discussion of his problems with sleep and his memories of particular dreams. He reports that he was afflicted with “night terrors” and “phantasmal noises” and haunted by sounds that his father made in his sleep. The early portion of the autobiography also documents episodes during childhood in which Symonds fell into trancelike states that continued into his adulthood, although with diminishing frequency. In a revealing comment on these trances, Symonds wrote, “Often I have asked myself with anguish, on awakening from that formless state of denuded keenly sentient being, which is the unreality: the trance of fiery vacant apprehensive skeptical self from which I issue, or these surrounding phenomena and habits which veil that inner self and built a self of fleshand-blood conventionality? Again: are men the factors of some dream, the dream-like state of unsubstantiality of which they comprehend at such eventful moments?” (58). Symonds believed these abnormal states of consciousness gave access to 25. Symonds’s letters make occasional reference to Sir James Paget, who was surgeon to Queen Victoria, the president of the Royal College of Surgeons, and author of Clinical Lectures and Essays (1875), Theology and Science (1880), and Studies of Old Case-Books (1891), all likely to have been of interest to Symonds.

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an “inner self ” more natural than that cultivated for society. In passages like this, one can glimpse how close he came to being able to accept what Coupland had argued: that to be abnormal was not necessarily to be unnatural.26 The passage is representative of others in its movement from the fact of a seemingly abnormal experience to an analysis of its significance to an understanding of mind more generally. Moreover, the issues he focuses on— whether truth is located in mind or body and how to access one’s “inner self ”—are those that undergird his understanding of homosexuality. The Memoirs make it clear that Symonds believed dreams provided almost unequaled access to his “inner self.” Particularly vivid is his recollection of a recurrent dream from childhood in which a disconnected finger moves about the room seeming to beckon him (38). Although he drafted his autobiography a decade before Freud’s Interpretation of Dreams, Symonds’s presentation suggests that he believed dreams functioned not simply to reveal self but also as a mechanism for self-analysis. After describing his first physical encounter with the boy his Memoirs simply call “Norman,” he writes, “After the long claspings of the first night with Norman, I dreamed. I dreamed of a lane of cypress trees and firs and cedars” (210). Similarly, after describing a recurrent dream centered on a vision of an angelic man, he ruminates: “Much might be written about the self-revealing influence of dreams and the growth of the inner man in sleep. This vision of ideal beauty under the form of male genius symbolized spontaneous yearnings deeply seated in my nature, and prepared me to receive many impressions of art and literature” (77). The idea that dreams, much like memory, nurture the aesthetic sense repeats itself in other ways as well, as when he includes in the Memoirs the following excerpt from a diary: Oh, this sleep toward morning, illuminated by a dream so piercingly sweet that it cannot be written. I can never in life be what I was last night in dreams; never so put my arm around another’s neck, so thrill at the touch of another’s throat and hand, so be fused into the soul’s essence of one beside me, so know that eternity is perfected and shut and sealed and rounded in a single moment. There are sublimer, more lasting, better, more real things in life than this. I never experienced them. But except in such dreams life has never become art, no poem has been lived by me. (198) 26. It is important to understand the context of Coupland’s claim, which he makes in the course of arguing for experimentation in psychological inquiry and for the importance of “Nature’s own method.” Coupland writes, “The abnormal is also natural; and, in accordance with the dictum that the knowledge of contraries is one, we should not expect full enlightenment on the workings of the sane mind until we had perceived the operation of such mind when released from the vigilant control of the will, and diverted from its healthy course by excess or defect of congenital ailment” (29).

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The conflict that he seems to confront without anxiety here —the profound disjunction between real life and dream life —surfaces at other points in the autobiography as a major source of his distress, the central dilemma of his “sick role.” As the Memoirs progress, Symonds becomes increasingly focused on the relation between dreams and desire, and his views reflect more overtly the influence of his moral anxiety. Although his “waking dreams”—“old dreams of the impossible love”—on occasion simply depress him, more often his despair intensifies into a severe sense of sin and shame. Writing that “vicious act is not so baleful to the soul as vitiated fancy,” he concludes, “In waking and sleeping dreams they run the whole round of desire, beginning with reveries that hardly raise a blush, advancing toward pruriency, dallying with the sensual ware, at last wading in chin-deep, deeper and deeper in, until no bottom is untried, and no part or portion of the deflowered soul is pure” (127). He repeatedly berates himself for his tendency to imagine — through the mechanism of dreams—idealized males who bear little resemblance to their real-life counterparts, and focusing on the uncontrollability of the imagination, the problems of the homosexual are likened to those of the hypochondriac. Evincing a profound distrust of the homosexual imagination—and counteracting passages in the Memoirs that pay tribute to the joys of satisfaction achieved through dreams—he wrote of Alfred Brooke: “I believe that the picture I have drawn of him as the dream object of my permanent desire is a gross libel upon the flesh-and-blood being he was” and “Let no one imagine that the man who bore or peradventure still bears this name, corresponded in any essential particular to the dream around which my unhealthily repressed desires crystallized” (128). Implied in this passage is the idea that it is not the desire, but rather than act of repressing desire, that is unhealthy. At another point in the Memoirs when he reflects on his relationship with “Norman,” he writes that “the real malady of my nature was not in the passion I felt for him, but in the self-conscious morbid and sophisticated way in which the passion expressed itself ” (213). In the end, however, Symonds associates his dreams with suffering, for, no matter how liberating and satisfying it was to experience them, they were inevitably transitory. Symonds’s distinctive way of associating invalidism with stasis becomes particularly clear at the end of the Memoirs. Here his narrative emphasizes not memory, sleep, or dreams, but rather the idea of awakening, understood both as a physiological function and as the psychological transition from imagination to reason. He writes, “But, when he comes to frigid reason’s self

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again, when he tallies last night’s deeds with today’s knowledge of fact and moral ordinance, he awakes to the reality of a perpetual discord between spontaneous appetite and acquired respect for social law” (283). Later in the same paragraph the term surfaces again: “When he awakes from the hypnotism of the flesh, he sees his own misdoing not in the glass of truth to his nature, but in the mirror of convention” (283). Such statements invert the logic of “coming out” and imbue the text with a sense of psychological inertia. Symonds “awakens” to a social self that decries his sexual inclinations as wrong, and his “true” sexual self remains an experience of imagination. In keeping with the confessional aims of the work as a whole, Symonds is careful to emphasize at his autobiography’s end that he achieved relative health only by “coming out” to the extent that he had. Noting that his success as a scholar occurred concomitantly with his first sexual relationship with another man, he asserts that together these demonstrate his newfound “selfmastery” and “self-control”: He seems to draw strength from the congenital malady which has now come to the surface. Upon the verge of fifty, this man is younger and wholesomer than when he went to Harrow at thirteen. He is easier to live with than when he married at twenty-four. He has to some extent surmounted his consumptive tendencies. . . . Altogether he is more of a man than when he repressed and pent within his soul those fatal and abnormal inclinations. Yet he belongs to a class abhorred by society and is, by English law, a criminal. (282–83)

The version of the invalid’s “pleasure in pain” thematic that Symonds offers here at his confession’s end is particularly vexed because it is rendered from a third-person perspective that lends the narrative the sterile qualities of case history. Yet this use of perspective helps to highlight his manipulation of the sick role. The clinical tone invoked here is interesting considering that, when published, the Memoirs would include material he had prepared for collaborative work with Havelock Ellis. (Symonds appears as “Case XVII” in Ellis’s 1897 study Sexual Inversion.) In believing himself to have become “younger and wholesomer” by acknowledging himself as homosexual, Symonds articulates a belief similar to Bulwer-Lytton’s claims for hydropathy’s power to restore the innocent pleasures of boyhood. Similarly, the author of Confessions of a Hypochondriac, having begun his text with the statement “I am old, and growing older,” seems also to have associated health—for him, freedom from hypochondria—with the recovery of the ability to “innocently experience” pleasure as

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he had in youth. Operating in different ways in these narratives, then, is a powerful critique that links male sexuality to invalidism, in part by seeking to expose adult male desire as healthy or unhealthy, curable or incurable. For Symonds, the self-inquiry led, perhaps inevitably, to an impasse. Although he had found through his study of Greek poetry evidence of “perfect Hellenic youth” (Arata 86), it was irrefutably associated with an ancient past. Bulwer-Lytton found comfort and refuge in an ailing brotherhood— his fellow New Monthly Magazine journalists and the symbolic community of men he believed similarly suffered from overwork and shattered nerves. Symonds also sought recovery within a community of men—in his case, most literally, the muscular Swiss peasants of Davos—but class consciousness, convention, and his own awareness of English criminal law undermined his satisfaction with himself. Moreover, if homosexual desire and pleasure provided in its manifestations passage to symbolic youth, his actual lived experience of childhood and adolescence was riddled with ill health and sexual pain that proved impossible to overcome. Focusing on the “bewildering contradictions” of mind and body, the Memoirs end not with a sense of liberation but rather with one of stagnation and inertia. That he is said to have delighted in a periodical reference to him as “that indomitable invalid” should thus not surprise. In a sense, Symonds’s Memoirs reveal the potency of invalidism as a model of identity when, as the century drew to its close, social persecution and legal prosecution combined to render homosexuality—and, indeed, the confessional impulse —more problematic than ever before.27 27. In using the phrase “model of identity” I am deliberately inserting the invalid into the taxonomy that James Eli Adams develops in his study of manhood. In Dandies and Desert Saints, Adams examines “interrelations among gentleman, dandy, priest, prophet, soldier, and professional as models of identity central to the rhetorical self-fashioning of Victorian intellectual men” (15).

3

“IN SEARCH OF HEALTH” Invalids Abroad

And there is nothing like the rattling of wheels to scare away blue devils. —Henry Matthews, The Diary of an Invalid Even at the present day, consumptive invalids are hurried away from these islands to the shores of the Mediterranean or elsewhere, with an unbroken faith in, or rather blind credulity, in the talismanic efficacy of foreign climates. —Dr. Thomas Henry Burgess, Climate of Italy

W

hen the mind is full of fret and fever, the best remedy is to put the body in motion,” wrote Henry Matthews roughly midway through his best-selling book The Diary of an Invalid: Being the Journal of a Tour in Pursuit of Health, in Portugal, Italy, Switzerland, and France, in the Years 1817, 1818, and 1819 (156). Having by this point in the narrative ventured from England to Lisbon and on to Pisa, Florence, and Rome as an invalid traveler, Matthews came to believe that motion helped to restore “equilibrium” between mind and body and bestow tranquillity on the anxiety-ridden sick person. However myriad his mental woes, Matthews’s invalidism clearly stemmed from physical sources as well, for interspersed throughout his travel account are references to cough, fever, and “pectoral complaints,” leading to the diagnoses of “decided pleurisy” (192) and “defluxion upon the lungs” (265) as well as references to a host of medical treatments he resorted to in his effort to find relief. Travel to places that promised warmer and more stable climates as well as greater variations of sights to see seemed to satisfy the needs of this English invalid—and 113

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many another—to say nothing of the myriad armchair travelers with no intention of leaving their firesides. Although Matthews’s narrative begins with the somewhat histrionic remark that he “can scarcely hope ever to see [England] again” (2), and though he at times complains bitterly that “it is as well to die of consumption as of ennui” (56), he returned safely home after thorough tours of Italy, Switzerland, and France and lived to see his Diary of an Invalid through three editions of the five that would be issued by 1835. Henry Matthews was not the only invalid to believe that motion itself could be beneficial to health. Over half a century later, John Addington Symonds would rhapsodize about the “magic of movement” in “Winter Nights at Davos” (448) and in a letter written from Davos would proclaim that “nothing is healthier & more resting than a long driving tour” (Letters 3: 367). Robert Louis Stevenson in a Macmillan’s Magazine essay titled “Ordered South” would link the attractions of railway travel to the sensations of a body “borne forward in the flying chain of carriages,” writing that “the stir and speed of the journey, and the restlessness that goes to bed with him as he tries to sleep between two days of noisy progress, fever him, and stimulate his dull nerves into something of their old quickness and sensibility” (68). The emphasis placed on the revivifying power of sensation and the medicinal value of motion provides a fascinating counterpoint to the association of invalidism with stasis. It also helps to explain the enormous popularity of travel literature by invalids, perhaps particularly with the newly mobile middle classes, for it underscores the significance of the tropes of “pursuit” and “search” so extensively employed by the many invalids who wrote travel accounts throughout the period. Whereas those who ventured only as far as the native health establishments of Malvern, Cheltenham, or Bath sought to benefit from the program of rest and retirement that—however intensive the level of social activity—was also part and parcel of the water cure, many of the invalids who traveled abroad “in search of health” placed their faith in the advantages thought to accrue from near-constant change of scenery. Their confidence is noteworthy, because it implies a willingness to confront the skepticism and scorn of a certain portion of the medical establishment. In Climate of Italy, for example, the physician Thomas Burgess was shocked to see patients whom he saw as “positively moribund, conveyed about this city, sight-seeing, under the impression that constant change of scene was as necessary for their cure as change of atmosphere” (qtd. in “Valetudinarian in Italy” 323). “Change of scene may, and does, produce good effects in nervous and dyspeptic invalids, or upon those exhausted by overexertion, shock, or mental anxiety,” he explained, “but what

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benefits it can accomplish in patients with organic disease, like tubercular consumption in an advanced stage, I am at a loss to conceive” (qtd. in “Valetudinarian in Italy” 323). Partly because the medical community never reached complete consensus in its understanding of the medical value of travel or change of scenery and the benefits of various climates, and partly because invalids affluent enough to travel abroad could so easily be seen as simply indulging themselves, narratives by and about invalids abroad foreground the specter of misplaced faith and delusion—the “blind credulity” that Thomas Burgess repeatedly decries in his characterization. Charles Edwardes’s Temple Bar essay of 1888, an exposé titled “Health-Resort Vignettes,” opens with the declaration that “it must first of all be assumed that the majority of people who go to a health-resort are not really in want of health” (205). The anonymous author of “A Voyage to Australia for Health” sardonically notes that during his journey “bad coughs became worse, and the real invalids began to despond” (413). Yet many invalid authors, well aware of such stereotypes and assumptions, exploited them in ways that demonstrate their genuine understanding of how medical condition and social role converged in the idea of a “search for health” and the control they were thus able to exert on their journeys. Deploying a range of rhetorical devices to deny a belief in, or even desire for, “cure,” many of their works posit “health” as forever elusive —being as subject to sudden changes in climate and seasonal variations as to other vagaries of experience likely to befall a British tourist abroad. The attitude mandated a sick role quite different from that of the hypochondriac desperate for relief. “I returned to England in a very much worse state of health than I left it,” grumbled the author of “A Voyage to Australia for Health” (416). As important, many invalid travel writers depicted health as most subject to the vagaries of their own dispositions. As Henry Blake put it at the conclusion of “Try the Bahamas,” “I had written this short paper in the interest of invalids who were recently put off from the health resorts of Europe by the cholera epidemic, and who might possibly be induced to try the effect of a perfect winter climate in an easily-reached British colony. But the invalid of whom I am thinking is always in search of health” (182). Blake’s characterization helps also to expose an important feature of the invalid as traveler. Although by definition associated with mobility, the figure nevertheless embodies a kind of psychological inertia, a stance that emanates, ironically, from a posture of endless searching and an insatiable thirst for change. Even the invalid fortunate enough to find health in a foreign country could not be sure to sustain it after returning home. The au-

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thor of A Letter to an Invalid about to Visit Madeira gloomily warns readers to “hesitate . . . before you determine to return to the fogs, easterly winds, and sudden changes, to which we are always subject in this country,” advising them further that “if in one winter, or in one year, you have gained benefit, remain another to secure that benefit” (16). However condemned by climate to be forever “in pursuit” of health, invalids abroad found much to identify with in the multivalent associations of that pursuit. Henry Matthews’s Diary of an Invalid found an especially wide reading audience, but a market for travel literature by invalids in fact thrived throughout the nineteenth century. The steady flow of such travel accounts throughout the period suggests that their appeal extended beyond fellow sufferers and that these texts satisfied cultural needs different from those of narratives adopting the private confessional stance. Many travel accounts either written by invalids or directed to them simultaneously served a population of armchair travelers in Victorian England. Indeed, the reader as armchair traveler was a familiar trope of nineteenth-century travel writing more generally, as one can see in the Fraser’s Magazine review of September 1849 titled “Recent Travellers.” Its author instructs his audience as follows: “Let the reader, then, settle himself down in his easy chair, and follow us on a trip into Switzerland and Sardinia, from whence we shall make a little excursion over Western and Central America; and, turning the world upside down, drop into New Zealand on our way home. The whole expedition will be dispatched in half-an-hour” (246). The anonymous “An Invalid’s Notes, and Rambles about Jersey,” published in 1861 in the National Magazine, also typifies the trend in its particular appeal to readers stuck in London. “On this eighteenth day of January, in the year of our Lord one thousand eight hundred and sixty-one, the weather being too dull and cold to incite me to out-o’-door exercise, I, an invalid, seat myself down close by a cheerful fire, and set to work manfully to render an act of gratitude to the scenery, climate, people, &c., &c., of this island of Jersey” (8). The author goes on to imagine himself “basking in a delicious warm sunshine, and inhaling a soft south wind, whilst London, perhaps, is thickly enveloped in fog, and all is misery and wretchedness in her streets” (8). Travel essays and books by invalids were not simply transparent guidebooks for the beleaguered. Works such as Nicolas Polson’s A Subaltern’s Sick Leave: Or, Rough Notes of a Visit in Search of Health to China and the Cape of Good Hope (1837), Captain William Jesse’s Notes of a Half-Pay in Search of Health: Or, Russia, Circassia, and the Crimea, in 1839 (1841), William Bullar’s Letters from Abroad, from a Physician in Search of Health (1861), John Nixon’s Among the Boers: Or, Notes of a Trip to South Africa in Search of Health (1880),

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and William Russell’s An Invalid’s Twelve Years’ Experience in Search of Health (1893) reveal the pervasiveness of the pursuit and search motifs. They also reveal the status of the invalid abroad as a representative type, a figure widely recognizable to the English reading public and commanding a particular kind of authority. Clearly, the invalid tourist adopted a very different kind of sick role than did the invalid who postured as a bedridden prophet or the hypochondriac who framed his story as confession. In some sense, the very different notions of readership that these types of invalid narrative construct might be linked to the variations in sick role their authors adopted. Ian Hacking’s argument for the ability of social change to create new categories of people that, in turn, provide new ways for people to be is especially relevant to this chapter’s concern with the figure of the invalid who journeyed abroad in search of health. The social identities of many such invalids were shaped not only by their status as tourists and as particular types of patients, but also by the fact that they traveled to seek relief from or cures for particular diseases, perhaps most notably tuberculosis, a disease with its own “chain of signifiers” (Herzlich and Pierret 28), some celebratory and others stigmatizing.1 The experience of travel itself invited invalids to consider their own agency in new and different ways; crucial issues of agency surface at nearly every stage of the invalid traveler’s narrative account—from the set of beliefs that make travel an option in the first place through the experiences that happen to the authors while journeying abroad, to the expectations that greet them on their return to Britain. As we will see, the emergence of a travel industry worked with certain aspects of medical belief and practice not only to provide the milieu necessary for the invalid to go abroad but also to help the invalid tourist achieve a form of cultural prominence. In short, so many destinations became linked with possible health benefits, and so many invalids journeyed to those destinations to test their medicinal value, that the figure of the invalid abroad became something of an expected feature of travel writing generally. Invalids in search of health were, in other words, visible features of the landscapes described by many nineteenthcentury travel writers. The figure’s prominence came at a cost, for the invalid’s very visibility ensured a complicated form of status in an age where antitourist attitudes developed alongside the prospering market for tourism. Rhetorical strategies used both in literature directed to the invalid traveler and in the narratives written by invalids abroad illustrate a multi1. Claudine Herzlich and Janine Pierret claim that through the advent of tuberculosis “the sick person crystallized existentially and socially, assuming its modern form” (29).

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tude of ways that the figure embodied anxieties about class and nationality, and the roots of these anxieties can be found in the very conditions that gave rise to their search for health. While issues of class and nationality are openly invoked in narratives by invalids abroad, gender more often operates below the surface, most obviously influencing which invalids sought to publish their accounts of travel. Most—though certainly not all—published narratives about a search for health were written by men in nineteenth-century Britain. Healthy men who had traveled abroad to accompany their invalid wives wrote a few such accounts; C. Home Douglas’s Searches for Summer and L. W. Champney’s essay “Our Invalid Wives” are examples. It would be tempting to explain the prevalence of men’s narratives organized around the “search for health” motif by reasoning that because the nineteenth-century ideologies of masculinity championed active exertion, men were encouraged, at least implicitly, to pursue health through travel while women, given their supposed fragility, were deemed more susceptible to the dangers of travel. Middleclass domestic ideology seems to discourage women, if only indirectly, from pursuing health through travel. While women’s travel writing prospered in Victorian England, the figure of the woman traveler constructed in these texts frequently displays a physical fortitude and vigor that appears to be incongruent with the female invalid. This incongruence no doubt accounts in part for the relative dearth of published travel accounts by women invalids and explains why when women such as Isabella Bird did travel for health, their accounts say little or nothing about illness and instead feature their exciting adventures on foreign shores. The many references to invalids abroad that pepper travel books from the period, combined with references to traveling for health in diaries and letters of the period, suggest that women and men were almost equally likely to leave home in search of health, whatever dominant ideologies of gender seemed to mandate. More subtle and more complicated explanations surely exist for the predominance of invalid narratives of travel written by men— explanations that take into account such factors as the differences in therapeutic regimens prescribed or recommended to men and women, the (gendered) occupational hazards that would likely result in disorders for which travel abroad might be undertaken, and existing assumptions about the forms of writing most suitable for men and women. A closer investigation of such factors would yield a more subtle and accurate explanation of why published invalid narratives were often written by men. Nevertheless, to foreground gender in one’s assessment of this literature would risk misrepresenting it, for other components of identity—most especially national-

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ity—play a more prominent role in the invalid author’s representational work. While masculinity is key to the confessional narratives by hypochondriacs examined in the last chapter, national identity is the concept that invalid tourists most often invoke and work through in their efforts to understand and represent a search for health. Surveying first the ways that a culture of tourism interacted with the emerging field of medical climatotherapy to promote the invalid’s “pursuit of health,” this chapter uncovers and assesses the rhetorical strategies that invalid authors use in their efforts to represent themselves as English men, as travelers, and as invalids. Henry Matthews’s popular Diary of an Invalid provides an especially compelling look at the confluence of these three dimensions of identity, and they converge as well in Lord Albert Denison’s Wanderings in Search of Health, issued in 1849 for private circulation, W. B. Aspinall’s San Remo as a Winter Residence (1865), and C. Home Douglas’s Searches for Summer, published in 1874. Later in the century, John Addington Symonds’s essays on his experiences at the Swiss health resort of Davos, collected in the volume Our Life in the Highlands (published at roughly the same time that he completed his Memoirs), reveal critical differences between Symonds’s public identity as an invalid tourist and his more private understanding of himself as invalid that occupied his attention in the more confessional, unpublished autobiography. Our Life in the Highlands can profitably be read in conjunction with a series of essays by Robert Louis Stevenson about his life as an invalid in Switzerland, for in evidencing shifts in late-century British medical understanding about travel and treatment that impinged upon the patients’ sense of agency, as well as the appeal of an emerging discourse of aestheticism to the invalid abroad, these texts build on yet simultaneously subvert conventions established in earlier narratives of the invalid abroad. “Colonies for the Consumptive”: British Invalids and the Wider World Nineteenth-century invalids with sufficient resources to leave home for extended periods were the beneficiaries of exciting new opportunities for travel outside Britain.2 Improved sailing ships and steam propulsion helped 2. It is often argued that until the nineteenth century only the very affluent could travel and that the Victorian period witnessed the democratization of travel. Some claim that the increasing numbers of middle- and working-class people who vacationed at British beach resorts prompted larger numbers of the upper-middle class to head abroad to distinguish their form of leisure. The complexities of class and travel opportunity are addressed insightfully by James Buzard in The Beaten Track. Directed

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to ensure safer, more regularly scheduled ocean voyages, and the rapid and widespread development of railways throughout Europe provided travelers with “hitherto undreamed-of mobility” (Distad 815). With the emergence of a travel industry that introduced the public to the travel agent and the conducted tour, these developments broadened the spectrum of travel opportunities throughout the middle classes. The variety of factors that further encouraged the development of a culture of tourism range from the economic and demographic to the political and intellectual. Acknowledging that the Napoleonic Wars had effectively extinguished the idea of the grand tour, James Buzard argues that the wars had nevertheless “both frustrated and nourished a demand for foreign travel,” a demand so intense that “after 1815 Britons seemed to explode across the Channel, heading abroad in greater numbers than ever before” (19). Men and women who identified themselves as invalids formed a significant portion of this tourist flock.3 Unlike many of their twentieth-century counterparts who, as Sheila Rothman reports, would associate the “banishment” of a prescribed trip for health with “ostracism and isolation,” most Victorian invalids considered travel for health a “privilege” (296n3). They were also all too aware that they shared that privilege with many others. With a characteristic sense of irony, Henry Matthews put it this way: “All the world is going to Rome —and every body says Rome is a charming place in the winter. What every body says must be true;—and I shall swim with the stream” (55). Similarly, the Bentley’s Miscellany author of “The Valetudinarian in Italy” placed invalids among “the throng of fashionable tourists . . . on the wing for, if not already luxuriating in, the glorious scenery of Switzerland and Italy” (319). Much later in the century the physician Morell Mackenzie described Tenerife as being “invaded . . . by crowds of sufferers, real and imaginary, with their friends and attendants” (123), and in a Westminster Review essay published in 1900, “The Invalid Abroad: Sketches

more to the particular issues raised by the figure of the invalid as traveler is Sheila Rothman’s observation that “treatment regimens were . . . linked to the gender and socioeconomic status of the sick; thus, it was appropriate for some to take long voyages and for others to take short trips. Some invalids were advised to go the West Indies for the winter, while others with less money and more familial obligations were advised to go to the mountains or to the seacoast for a shorter time” (Living in the Shadow of Death 262n19). 3. Sheila Rothman charts an interesting parallel development in the United States, noting that the “powerful myth” of a western cure that enticed American invalids to head westward in search of health required “practical assistance to be realized on a grand scale” and that assistance came in the 1870s with “the completion of the transcontinental railroad and concomitantly the appearance of a throng of town promoters” who “gave an entirely new force to the idea of the West as therapeutic” (140).

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of Invalid Life in the High Alps,” Simeon Lindon referred only half sardonically to “the great invalid herd” encountered there (88). Victorian and Edwardian travelers felt an intense need to justify these trips abroad, and most accounts from these periods make some attempt to establish “motives” for travel. As John Pemble writes in The Mediterranean Passion, “Pilgrimage, culture, and health were part of the special language of Victorian and Edwardian travellers; and the function of this, as of all languages, was dissemblance as well as elucidation. The fact is that pilgrimage, culture, and health were sometimes not motives but either rationalisations of motives that were less easily defined or excuses for motives that were less readily admitted” (96). The “search for health,” however fraught with uncertainty or linked to the purported “incredulity” of the sufferer, seemed to endow travel with a measure of legitimacy, in part because health was so ineffably linked to the ideals of pilgrimage. The sense of association goes some way toward explaining why, as Sheila Rothman reports, so many invalids brought along the Bible and Pilgrim’s Progress, works that “set the frame for their own journ[ies]” (58). “By fusing Christian’s quest for the Celestial City with their own search for renewed health and spiritual redemption, the invalids translated medical prescriptions to travel into a religious quest,” she observes (58). It would be misleading to suggest that all, or even most, British invalids traveled with a sense of such serious purpose, but many an invalid tourist was led, like Lord Albert Denison, to reflect on the allegorical significance of the search for health. Contemplating “the uncertainty of all that has to do with this life,” Denison and his wife waxed philosophical in their travels across Greece, concluding that “a longer journey might be at hand” and that “before the close of another year, either or both of us might be summoned to that far country whence no traveller returns” (73). Although most narratives by invalids who ventured abroad establish motive by beginning with some sort of declaration that they traveled “in obedience to medical advice,” the authors nonetheless benefited from the values attached more broadly to the paradigm of the tourist as a sort of cultural pilgrim. The practical appeal of living abroad no doubt contributed to many a decision to leave England as well. When the young consumptive Emily Shore recorded in her journal that her family was considering moving her to Madeira, she noted that her father would also benefit from opportunities for work and cheaper living. Literature marketed to invalid readers but written by the presumably healthy was no less concerned with self-justification. The author of A Letter to an Invalid about to Visit Madeira claimed that he had been so “frequently applied to for advice and informa-

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tion that may be useful to the Invalid” that he “ventured to print the few observations he has to make on the subject” (preface). Simeon Linden proffered his “hints and suggestions” in a similar spirit, suggesting that they were served “in more palatable form than those to be found in the orthodox pamphlet or popular medical tract” and that they would “stand the invalid of untried experience in good stead and save him not a few knocks and buffetings” (85). The invalids who embarked on a search for health both participated in and helped to create the emerging culture of tourism. Phrases such as “invalids and lovers of sunlight generally” (Mackenzie 120) appear so often in travel narratives of the period that the term “invalid” sometimes seems to function interchangeably with “traveler” and “tourist.” The conflation of the two terms is evident in the opening sentence of Henry Blake’s “Try the Bahamas”: To the invalid who annually flies southward from British frosts and fogs, as to the tourist seeking rest and recreation under brighter skies, a short sketch may be interesting of a group of islands but little known, where eternal summer may be found, where frost, fog and cold winds are unknown, where sufferers from lung affections may find health and strength, lovers of Nature explore new fields of research, and lovers of the beautiful revel in unsurpassed splendour of form, and colour, of earth, and sea, and sky. (174)

Wandering through Greece, Lord Albert Denison remembered having learned from his classics that it was “the fashion in those days at Athens for invalids and travellers alone to cover their heads” (41). Invalids inherited for better and for worse many of the conditions that went along with tourism. Focusing primarily on the services of the Thomas Cook Company and on the proliferation of the ubiquitous Murray and Baedeker guidebooks, James Buzard charts the evolution of “a coordinated, interlocking system of institutions and conventions extending out into the wider world to enable and shape tourist ideals” (49). Like their compatriots, invalids relied on this system to know where to go and what to expect, what to see and when to see it. Gazing on Cape Girão, the loftiest precipice in Madeira, the invalid Emily Shore wrote, “Had not the ‘Rambles in Madeira’ prepared me for disappointment, I should have been disappointed, for certainly one does not easily realize to one’s self its immense height” (342).4 Matthews’s Diary of an 4. Shore likely refers here to A. Lyall’s Rambles in Madeira and in Portugal, published in London in 1827.

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Invalid is replete with passages that make sardonic reference to guidebook directions, as when, during his journey to Rome he encounters the rainswollen Ricorsi and writes, “The Guide Book informs you, quaintly enough, that you will have to pass it four times—if you are not swallowed up in either of the first three” (59). Despite all their attention to periods of gradual improvement and moments of relapse, the invalids who wrote travel accounts were every bit as concerned as their more healthy counterparts to keep up with the standards dictated by guidebooks for where to go and what to see. “Oh, the daily labour that I allotted to myself, and in which I persevered without respite or flinching, to get through the various sights,” pronounced an exhausted Lord Albert Denison. “Forty-six churches are reckoned worth seeing” (236). Most invalids supplemented standard travelers’ fare with literature directed more specifically to their “requirements” as invalids. Bradshaw’s Invalid’s Companion to the Continent, a guide issued at midcentury by George Bradshaw, the travel entrepreneur who built an industry out of railway guides, exemplifies this type of supplementary literature. As John Pemble reports, “More and more of the published literature on the Mediterranean was aimed at the invalid market” (85). At various points throughout the century, particular regions or locations developed reputations as fashionable health resorts. Pemble observes, for example, that the therapeutic appeal of Pisa, Rome, and Naples competed with Malta, Malaga, and Algiers during the first half of the century. The French Riviera enjoyed a nearly steady supply of British invalids who adopted it as “their winter sanatorium” (Pemble 86). As René Dubos and Jean Dubos put it, “Nice was the most fashionable rendezvous for those who tried to dodge death every winter by escaping from northern frosts” (20). When established resorts became too crowded, invalids—demonstrating what Pemble calls “a frontier mentality”—moved on to smaller, less-frequented places.5 Morell Mackenzie’s essay “HealthSeeking in Tenerife and Madeira” illustrates well medicine’s intervention in the construction of fashion, for it provides precise details on exactly which cities were best suited to consumptives in the “first” and “second” stages of their condition; which places were beneficial for bronchitis with secretion or without; elevations suitable for asthmatics; where to assume residence if suffering from kidney disease; where to convalesce from scarlet fever. Nev-

5. Pemble’s observation provides a way to see British invalids in the South as counterparts to the American invalids who went West in search of health. For an excellent discussion of the conflation of frontier mentality and western narrative in the experience of American invalids, see Rothman 131–75. Billy M. Jones’s Health-Seekers in the Southwest, 1817–1900 also explores this topic.

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ertheless, disagreements about the efficacy of particular locations persisted throughout the century, with rival claims emanating from physicians as well as patients. The barrage of such testimonies resulted in confusing and contradictory messages. As Sheila Rothman summarizes it, “No one climate was right for everyone, yet almost any climate might prove efficacious for someone. The net impact was to send consumptives scurrying first to one island and then to another in search of a cure” (22). It is no accident that the role of the invalid assumed its status in British culture at the same historical moment that the figure of the tourist rose to prominence.6 If the tourist is the consummate “pampered unit of a leisure industry” (Buzard 2), the invalid merely took the figure to its logical extreme. While abroad, Lord Albert Denison decided that “were [he] to live out of England, no part of the world would offer to [him] such attractions as Corfu,” indicating that there he could be ensured of “first-rate shooting,” the “finest yachting, boating, and sea-fishing in the world,” as well as the “protections of the British government,” “regular communication with England,” and “above all, very cheap living” (197). Tracts directed to invalids journeying abroad were filled with tips such as those set forth in A Letter to an Invalid about to Visit Madeira: for example, “Do not be afraid to take with you a sufficient supply of warm clothing” (6) and “The warmth of the climate will not allow of good butter being made. Previously to your departure from England, you can make arrangements at Falmouth for supplying the deficiency” (8–9). In “Health-Seeking in Tenerife and Madeira,” Mackenzie warned of “a great deal of dust, which is very trying to invalids” (126) and provided information on specific villas in which “invalids can be very comfortable” (130). Reminding his readers that “the comforts of a place are as important to an invalid as the climate,” Henry Matthews filled his Diary of an Invalid with recommendations for specific hotels, singling out for special praise those where with relatively little expenditure one could be assured of such comforts as “a good room, an excellent dinner of two courses, with a dessert, and as much of the wine of the country as you like” (37). Even more than their extra attention to privileges, conveniences, and comfort, what distinguishes invalids abroad from the many other British tourists who surrounded them is that their health requirements seemed to provide them with a special dispensation to stick to “the beaten track,” however riddled this path with the negative associations of the tourist. That 6. Tracing the origin of the tourist to the late eighteenth century, James Buzard argues for the significance of the term’s demarcation from “traveler,” relating tourism (and the idea of antitourism) to industrialization and democratization as well as to the concomitant emergence of leisure as a central social arrangement (4 –5).

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British invalids were conscious of the meaning of traveling along the “beaten track” is everywhere evident in their narratives. Remarking with wonder the solitude that surrounded him on the ship transporting him to Lisbon, Henry Matthews remarked: “We have not yet encountered a single sail; and I had imagined that, in so beaten a track as we are pursuing, we should have met ships as thick as stage-coaches on the Bath road” (5). No less sensitive to the cultural mandate that one seem more like a traveler and less like a tourist was the author of “Health-Seeking in Tenerife and Madeira,” who acknowledged that “only a few adventurous spirits had carried their search for sunshine so far out of the beaten track” and that “to the average invalid Tenerife was as much outside the sphere of practical healthseeking as Timbuctoo” (120). Despite such overt acknowledgment that any travel outside England carried with it a measure of antitourist pressure, invalids were only partially subject to the such pressures. Medical belief in the value of “change of scenery,” to the extent that it existed, further justified a tourist mentality, particularly for the overworked invalid who traveled to replenish an exhausted nerve force. Ironically, the dispensation to behave like a tourist may have enabled rather than undercut invalids’ sense of agency abroad. They arguably experienced greater liberty than the typical tourist by being “allowed,” and even expected, to travel to those places already discovered by others to have the qualities likely to secure temporary comfort, if not permanent health. More significant, adopting the mantle of tourist seems to have recast the experience of being a patient in such a way that it too was accorded more agency. Even while travel accounts by invalids make frequent reference to the role that “medical advisors” may have played in initially recommending travel to a warmer climate, most represent invalids as essentially on their own abroad, making their own choices about where to go and what to see. “Plan of journey I formed none,” writes Lord Albert Denison at the beginning of the aptly titled Wanderings in Search of Health (2). “It must be borne in mind that as much responsibility rests with the patient as with the doctor,” warns the author of “A Voyage to Australia for Health” (412). Many invalids seem to have obeyed medical advice sought while abroad only when it matched their own needs or instincts, as when Henry Matthews insisted, over the protests of his Roman surgeon, that more blood be drawn (212–13). Most influential for invalids who embarked on a search for health was the emergence of climatotherapy, a form of nature therapy based on the assumption that fresh air, exercise, and removal from sources of stress and fatigue were essential to recovery. In this respect, climatotherapy was much like hydropathy. The physician Charles J. B. Williams, an authority on pul-

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monary disease and author of Lectures on the Physiology and Diseases of the Chest, instructed his fellow physicians to prescribe “the purest air and the most suitable climate for regular and ample exercise in it” (246–47). Particular climates determined how much fresh air and exercise a patient could take and, depending upon their properties, operated as a natural depressant or stimulant. “Victorian climatotherapists paid minute attention to the effects of different climates on the nervous and digestive systems,” writes John Pemble, noting further that they decided that, as a broad principle, climates were either tonic and exciting, or sedative and relaxing. They could be used either to liven a patient up, or to calm him down. Which type a patient required depended on whether his malady was inflammatory and feverish, or a disease of debility; and this was determined by his pulse rate, his general temperament, and the nature of his dyspepsia. . . . Correct classification and assortment were essential because sending an invalid to the wrong climate could, as it were, short-circuit his system. (91)

The emerging field constructed and classified types of invalids, each with distinctive medical needs that could best be served by particular climates. Although the field originated as medical science, it quickly became popularized in such a way that many invalids believed they were equipped to direct their own therapeutic regimens. One reason for this is that the boundaries between texts that functioned as medical science and texts that functioned as travel literature were not clearly drawn. James Clark’s influential The Sanative Influence of Climate, for example, was subtitled With an account of the best places of resort for invalids in England, the South of Europe, &c. By 1862 the physician Scoresby Jackson could creditably claim that medical climatology was “every day taking a stronger hold upon the minds not only of medical men, but of the general public” (qtd. in Pemble 92). Conversely, many invalid-written accounts make so little overt mention of health issues that they appear and function as more generic travel literature. Sheila Rothman captures the ambiguity when, discussing the consideration physicians gave to climate, air, and exercise, she notes that they “gave most prominence to climate, although its benefits were almost inseparable from exercise and, curiously enough, from the very act of travel itself ” (18–19). The assumptions that invalid tourists took abroad were to a great extent shaped by how they were classified as patients. Two kinds of invalids, both of whom may have opted to undertake travel as part of a therapeutic regi-

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men, were particularly conditioned by medical climatology.7 On the one hand, invalids suffering from nervous disorders would very likely have encountered medical professionals urging on them, if not actually “prescribing,” a “change of scenery” or “change of air.” The Young Northern Traveler: Or, The Invalid Restored typifies the paradigm in its deference to the “excellent physician” and “medical advisor” who counsels the young hero to take a respite from the “labour of thinking” and set sail with his uncle on a voyage to the Baltic, after which the patient enjoys “the happy restoration of his health” (167). Indeed, in a September 1849 review of travel books in Fraser’s, the author suggests that physicians themselves were prompted by the perils of their profession to follow their own medical advice. Referring specifically to John Forbes’s A Physician’s Holiday: Or, a Month in Switzerland in the Summer of 1848, the reviewer remarks that “it is the well-known practice of the leading physicians of London to take a holiday at the close of the summer, to recruit their health and spirits, and brace themselves for the labours of the ensuing season” (“Recent Travellers” 246). The Victorian medical assumptions that attributed a loss of “nerve force” to overwork and mental anxiety led inexorably to the belief in sending a patient away from home or work. “A large proportion of the stream of invalids flowed toward the ocean, to Brighton, Bournemouth, Ramsgate, Margate and other seaside communities,” Janet Oppenheim reports (124), to benefit from the purportedly restorative power of sea breezes. Others undertook sea voyages to take advantage of even more invigorating ocean breezes, inspired no doubt by the many physicians who believed that the “sea voyage had potential not only to cure consumption but also to prevent it” (Rothman 19). In 1836, beleaguered by a cough that would not subside, Emily Shore wrote in her journal, “There is certainly danger of my lungs becoming affected, but we trust that, if it please God, the sea will restore me to health and remove the possibility of consumption” (140 –41). Calling herself “an excellent sailor,” Shore wrote on board ship: “My cough is almost gone, and I never wake up feverish and throbbing as I did in England. Really I shall hardly be an invalid when I reach Madeira” (290). Henry Matthews was less sanguine, writing while on board ship: “I am told that a sea-voyage, to be of any benefit to an invalid, should be made in a frigate, or other vessel of equal size; but of this I doubt;—for all comfort is 7. Advancing an argument parallel to that of Oppenheim in “Shattered Nerves,” Billy Jones attributes the growth of the trend toward climatic therapeutics to “the failure of formal medicine” (125). See also Pemble’s discussion of medical climatology (84 –96).

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so entirely out of the question at sea, that I think the difference of as little importance as the choice of a silken or hempen rope would be to a man at the gallows” (30). Many invalids who wrote travel accounts came from yet another community of nervous patients, those who headed to the mythic sunny South, especially Italy and the French Riviera. Concluding from the “droves of British invalids” who flocked to the Mediterranean that the area combined “all the reputed benefits of sea air, abundant sunshine, and novel surroundings” (129), Oppenheim notes, “The great thing about the Mediterranean, its promoters were quick to point out, was that its climate was varied enough to serve all types of patients: in parts of Italy, the principal effect of the atmosphere was sedative; in areas of the Franco-Italian Riviera, it was mildly tonic; elsewhere still, it was extremely exciting” (129). Small wonder, then, that more and more Victorian doctors “came to the conclusion that the Mediterranean could do more to revitalize body and mind than all of the British pharmacopoeia put together” (Oppenheim 129). Not all invalids who undertook travel did so with complete faith in the veracity of their physicians, however. The author of Confessions of a Hypochondriac concluded that one physician who advised him to travel did so “to get rid of me I suppose,” and explained, “This is the usual way of disposing of a patient of my class” (75), referring as much to his financial resources and social standing as to his status as a hypochondriac. If nervous invalids constituted a major subset of English traveling patients, invalids with pulmonary disorders or consumption—“lungers,” as they were sometimes called—constituted another.8 For these patients, the value of change of air and change of scenery could be understood far more literally, and the Mediterranean appealed primarily as a refuge from cold and damp. Lord Albert Denison reported that he embarked on his journey when “after six weeks’ confinement to a sick room, the state of [his] chest causing [him] to experience the sensations of a fish taken out of water and gasping in another element, [his] medical advisers determined that [he] was sufficiently recovered to leave England for a winter in a warm climate” (1). Later in the period the Alps, or “Swiss Highlands,” accrued mythic ap-

8. Although the term “consumptive” generally referred to men and women who suffered from a chronic but early stage of pulmonary disorder, it also embraced those suffering from late-stage “phthisis” as well as “scrofula.” As Sally Mitchell notes in the entry “Tuberculosis” for Victorian Britain: An Encyclopedia, “the nonmedical term ‘decline’ and the medical diagnoses of asthenia, tabes, inflammation of the lungs, hectic fever and gastric fever are also common designators for illnesses that were probably tubercular” (822). For more on the subject, see The White Plague: Tuberculosis, Man and Society by René Dubos and Jean Dubos.

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peal similar to the South. These were the “colonies for the consumptive” referred to in Simeon Linden’s “The Invalid Abroad,” an essay using ethnographic tropes to evoke an “imagined community” of invalids (85): “Here his species congregate in large numbers and develop many traits and peculiarities which have even enabled one to single out from his class certain types not altogether unworthy of the notice of his fellow-men” (85–86). Noting “long previous familiarity with the health-stations of the Riviera,” John Addington Symonds and Margaret Symonds commenced Our Life in the Swiss Highlands with a view toward recording the advantages that Davos and “high Alpine air” in winter offer to invalids, particularly “people suffering from lung troubles.” Reporting that “phthisis . . . became the disease with which Mediterranean travel was most commonly associated,” John Pemble makes the important point that these patients were “ordered South” not because of “any false ideas about the disinfecting properties of the Mediterranean atmosphere” or because the climate ensured cure, but rather because their physicians were signaling a “growing recognition of the impotence of specifics and local applications such as inhalants to combat these endemic afflictions” (88). James Clark’s The Sanative Influence of Climate and Scoresby Jackson’s Medical Climatology were just two of many medical texts to warn fellow physicians and invalids alike against investing place with too much power to cure. As a form of nature therapy, climatotherapy, much like hydropathy, had its fair share of advocates as well as detractors. In Climate of Italy Dr. Burgess found the opportunity to proclaim that “no greater popular delusion prevails, than the belief in the existence of some undefinable specific virtue in the climate of Italy, for pulmonary consumption” (qtd. in “Valetudinarian in Italy” 322). Despite —or perhaps because of—invocations for caution and warnings against delusion, a kind of counterattitude simultaneously emerged in more popular literature directed to the invalid tourist. For every physician who warned of the overly credulous patient who could not be dissuaded from making a journey abroad, “only to die upon arrival,” there was a layperson ready with a success story.9 One tract titled A Brief Letter of Advice to an Invalid is confidently written by a self-proclaimed “Ex-Invalid.” The author of A Letter to an Invalid about to Visit Madeira describes himself as a “watchful attendant on one who, when she left England,

9. The boundaries between scientific studies of health resorts and popular narratives directed to lay audiences are far more permeable than may be implied here. In “Davos in Winter,” for example, John Addington Symonds refers his readers to a series of scientific studies, some written in German and some published in the Lancet (86).

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was pronounced to be in the last stage of consumption, and who very slowly regained, in the lovely climate of Madeira, the health which she now enjoys” (3). Even the more circumspect John Addington Symonds wrote in the Fortnightly Review essay “Davos in Winter” that “if you go there ill, it almost always happens that you come away well” (76) and that “though Davos owes its reputation to the cure of pulmonary diseases, nearly all chronic cases of debility, whether nervous or resulting from the weakening effects of fevers, are known to do well there” (87). When Thomas Burgess wrote scathingly in Climate of Italy of sanative effects that were “purely imaginative,” he exposed one of the ways that the figure of the invalid tourist shaded into that of the hypochondriac and took on overtones of the impostor. Burgess claimed that the appeal of Venice to invalids “is not . . . the chemical constituents of the atmosphere, nor the supposed salubrious influence of the climate,” but rather “the magic of its name” (qtd. in “Valetudinarian in Italy” 323). Burgess sought to defend modern medicine, both to safeguard the institutionalized approach and methods from quack nature therapies and to distinguish modern medicine from its primitive past of miracles and magic. It is not surprising that he used the Lancet to voice his opinions, commenting in 1850 on the “inutility of resorting to the Italian climate for the cure of pulmonary consumption” (10). A few invalid authors adopted a similar stance, using their travel narratives to counteract what they saw as overly zealous and inaccurate reports of the restorative powers of various health resorts. “I am far from denying the good effects, in certain cases, both of the sea-voyage and of residence in Australia; but I think the number of such cases is greatly exaggerated, and that the remedies are often applied where they are quite unsuitable,” wrote one author, before concluding that “in nearly all respects I do not hesitate to say that Australia is an unfit place at present for any one who may be called an invalid” (“A Voyage to Australia for Health” 417). This attitude goes some way toward explaining the many ways that “self-help” commentary surfaces in narratives written by and for invalid tourists. No invalid should place so much confidence in climate that he “neglect[s] other circumstances as essential to his recovery,” warned Morell Mackenzie, who concludes his exhaustive study “Health-Seeking in Tenerife and Madeira” with the caveat that “climate in fact only helps those who help themselves” (135). With slightly less moral fervor, John Addington Symonds reminded his readers considering travel to Davos to bring with them “some mental occupation” to help battle the area’s “bracing monotony” and so to ensure the “cheerful spirits so important to recovery” (“Davos in Winter” 87). Self-help comments like these infuse nearly all travel accounts

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by invalids and accumulate to suggest that this particular version of the nineteenth-century invalid was believed to be more susceptible to peril and consequently more responsible for safeguarding self than the invalid safely confined to a sickroom at home. Beliefs about national identity loom large in the invalid tourists’ accounts, perhaps because their sick roles were performed outside England. Turning to Henry Matthews’s Diary of an Invalid, this chapter will explore the ways that travel narratives exploit the power of invalidism to signal both medical condition and social role, as well as the multiple ways that invalids allowed their beliefs about national identity to direct and give meaning to their “pursuit of health.” “ To an English Eye”: The Invalid as Tourist Henry Matthews’s Diary of an Invalid ends with a passage dated 10 June (1819), written on board the ship that would transport him from Dieppe back to England. Recollecting a poetic tribute to Britannia, Matthews writes, “Long may she retain her sceptre!—and long may she continue to inspire such feelings as now rise within me in approaching her shores, and make me exult in the reflection that I was born an Englishman” (475). His patriotism had begun its rapid and steady ascent the day before, when he wrote, “Oh England! England! thou land of liberty—thou climate of good sense —thou tenderest of mothers and gentlest of nurses” (473). Despite the dire predictions that characterize the opening passages of his travel account, when he was sure he would never again see his beloved homeland, Matthews returned with what he believed to be “amended health and brighter prospects” (474). As these ebullient last pages imply in equating climate with morality and virtue, the health that Matthews pursued abroad encompassed more than the purely physical. His sense of national pride was evidently as much in need of restoration as were his overwrought nerves or delicate lungs. However changeable its nature and unsuitable to this particular patient’s needs, the English climate to which he returned was confidently described as cultivating a solid and medicinal “good sense.” At first glance, the ending of The Diary of an Invalid seems diametrically opposed in spirit to its beginning, when Matthews compares himself to “honest Tristram Shandy” about to depart on “a wild goose chase after health” (1). But both episodes illustrate an important dimension of Matthews’s narrative voice, for he uses self-reflexive commentary throughout his account to establish his credibility with readers. The credibility in this instance derives from the way he rhetorically distinguishes himself from

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other invalids who presumably embark on health journeys that everyone else recognizes as hopeless. However debilitated he is in body or however demoralized in spirit, Matthews claims the good sense to know what and what not to expect from his journey. This fund of common sense saves him, he at other times implies, not simply from the trap of hopefulness set for the invalid tourist, but also from the unrealistic expectations for authenticity likely to beguile the less knowing traveler. “Of the sights at Rome it is impossible to say any thing new. What so many have told, who would tell again?—I must be content to record first impressions,” he tells himself and his readers, not with an air of resignation and disappointment, but rather as evidence of the intelligence and sound judgment with which he undertakes his role. This same tone comes through at other times when Matthews uses his Englishness to account for the situation of the tourist. “There is something disagreeable at first to English feelings, in making a previous bargain for your entertainment at an inn,” he writes, “but it is the only way of securing yourself from a greater evil—a final dispute” (276). Indeed, throughout The Diary of an Invalid, Matthews introduces himself as one with the typical tourist’s sense of uncertainty when about to depart for unknown parts of the world or encountering them for the first time, but also as one well prepared not to be deceived or otherwise taken advantage of—in other words, as the perfect tour guide for his readers. In The Diary of an Invalid Matthews constructs a readership of armchair travelers who are solidly English in their expectations, assumptions, and interests. Comments such as “the moon, in this latitude, has a silvery brightness which we never see in England” (6), “a poor little bird, of a species unknown in England” (7), and “a striking novelty to an English eye,” abound at the narrative’s beginning, gestures designed as much to dramatize the foreign qualities of the journey as to create solidarity between him and his readers. In such passages, Matthews’s overt attention to what the “English eye” registers on his journey makes concrete the work of the tourist gaze that he deploys for his readers. Like Henry Matthews, many nineteenth-century travelers who sought the clout of the “antitourist” invoke what James Buzard calls the “romantic gaze,” one that claims private access to genuine culture even while it depends on a rhetorical “crowd” of tourists whose identities and “views” it claims to reject (153). This argument helps to explain Matthews’s efforts in The Diary of an Invalid to construct a distinctively English readership. Often reminding his readers that he is “one of them,” Matthews makes uncomfortable commentary more palatable, as when he concludes a lengthy

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section on Napoleon with the comment: “What[ever] we may think of him in England, he is the great idol of adoration in this country” (271). By so frequently introducing the idea that what he sees and encounters is “unknown in England” or new “to an English eye,” he garners the symbolic rewards of the allegedly authentic. The “crowd” that his claims depend on is not composed of other tourists following the same beaten path that he follows but of people who, confined to their homes and armchairs in England, can little imagine the sights he sees. In this way, Matthews posits his readership as benefiting from the kind of “translation” he offers. Moreover, he reinforces the relationship by continually acting the role of translator, with commentary such as “the dinner alone in England would cost more than the whole daily expenditure” (38). Of a particular kind of wine available in Rome, he informs his readers that it “costs us little more than a paul a bottle; and a bottle holds nearly two English quarts. The paul is something less than sixpence, forty-four being the value of a pound sterling, when the exchange is at par” (62). Writing at another point that “the inns of Italy are generally better than those of an equal class in England,” he poses the rhetorical question, “What can a traveller hope to find at a country-inn in England but the choice of a beefsteak, a mutton-chop, or a veal cut?” (60). Matthews’s credibility as tourist and tour guide eager to translate foreign culture into something meaningful to an English audience at home is built on his willingness to call a spade a spade. He admits, for example, that “in that great article of a traveller’s comfort— his bed—Italy has again the advantage” and that “instead of the suffocating feather-beds of England, you find there an elastic refreshing mattress, which will conduce to ensure a good night’s sleep, in spite of the dreary unfurnished room in which it is placed” (60). In a similar spirit, he concludes that the Italian custom of providing each dinner guest with his own decanter of wine is much preferable to the English tradition of passing the bottle, and later that “they manage their Theatres better” as well (282). Matthews’s efforts to represent the foreignness and newness of what he encounters abroad compete throughout The Diary of an Invalid with passages that attest to, without exactly bemoaning, the myriad ways tourism has transformed “authentic” foreign culture into something more hybrid. “The English abound so much in Florence, that a traveller has little occasion for any other language,” he notes before observing that “at all the hotels, there is some one connected with the house that can speak English. English shops abound with all sorts of knickknacks—from Reading sauce to Woodstock gloves;—and the last new novels stare you in the face at the li-

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braries” (38). Although at times he seems simply to document this presence, at others he becomes more antitourist in tone, as when he writes that “the English swarm every where” and when, after finding “all the inns full,” he describes Rome as “like a country town in England at an assizes” (61). But Matthews also positions himself among the community of English men and women abroad in far less antagonistic ways. Of the reaction to news of Princess Charlotte’s death, he reports that the chargé d’affaires in Florence had written to the grand duke “on the part of the English, to excuse their attendance at a ball and supper,” and that “all the English put on deep mourning” (46). Matthews indulges in criticism of the English presence abroad only when it compromises his comfort or seems to deprive him of the cultural experiences he yearns for. In The Diary of an Invalid, Matthews makes it clear that it is not only a set of experiences (or lack thereof ) that define the Englishman as English, but also his attitude and standards. Here too his assumptions surface most vividly in the context of the supposed opposition between the traveler and the tourist. Describing the streets of Lisbon, Matthews writes, “Though travellers may have exaggerated the beauties of the view, I have seen no description that does justice to the indescribable nastiness of the town” (10). Matthews sets himself up in contrast to this type and postures as the curmudgeonly tourist and tour guide, able to see things as they really are. “Of the great majority of sights, it must be confessed that all we obtain for our labour is—the knowledge that they are not worth seeing;—but this is a knowledge that no one is willing to receive upon the authority of another, and Vasi’s plan offers the most expeditious mode of arriving at this truth by one’s own proper experience” (63). Much later in the diary he observes that “the more you travel, the less you will rely upon the descriptions of guides and itineraries,” concluding that “all you collect from them, in general, is the ignorance of the compilers” (252). In this and many other respects, The Diary of an Invalid reads like a travel account that might have been written by any British traveler or tourist, not necessarily one suffering from overwrought nerves and damaged lungs. More so than many of the invalid-written travel accounts that would follow, however, Matthews’s work does in fact narrate a search for health. The representation of this search is interwoven with the more generalized story of the British tourist abroad that evolves as the diary unfolds rather than simply running parallel to it. Moreover, just as Matthews adopts the tone of the commonsensical curmudgeon to establish his credibility as tourist and tour guide, so too does this tone enable him to depict himself as a particular type of invalid abroad.

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Matthews draws attention to his own self-representational strategies in his opening pages: “In obedience to medical advice, I have at last determined to set out upon a wild goose chase after health, and try, like honest Tristram Shandy, whether it be possible to run away from death” (1–2). The allusion is crucial to Matthews’s attempt to introduce himself to readers as an exemplary tourist and tour guide, and it is also critical to his role as an invalid. Matthews purposely undercuts the authority of “medical advice” and the patient’s supposed submission to this authority by simultaneously emphasizing his own agency and self-determination in making the decision to travel. Equating medical advice with the “wild goose chase” he is about to embark on further undermines institutional authority even while it enables him to play self-reflexively with the idea of his own credulity. Likening himself to “honest Tristram Shandy,” he accepts as fiction the idea that the search for health will be satisfied, that death can be defeated. In this sense he constructs himself as the very opposite of the deluded invalid desperately hoping for health abroad.10 If Matthews is careful to distance himself from this particular type of invalid, his narrative is nevertheless interspersed with abundant references to his ill health. The diary records episodes ranging from “a week of severe illness” to less-defined periods of convalescence after emerging from sickroom confinement. Some passages tend toward the succinct, as when he writes “seized with an acute pain in the side” (192) or notes “a fresh attack of pleurisy” (208), and others afford him opportunity to indulge his philosophical inclinations, as the following passage shows: 5th. My health grows worse and worse! Constant irritation.—Day without rest—night without sleep;—at least sleep without repose, and rest without recreation. If life, with health and wealth, and all “appliances and means to boot,” be nothing but vanity and vexation of spirit, what is it, alas! when deprived of these embellishments? (154)

10. This is one of several references to Tristram Shandy that betray a bit of confusion on Matthews’s part. In Sterne’s novel, Tristram is a traveler only in a metaphorical sense —he is on a journey through the life of a mind. He is preoccupied with health and death, though. It is Yorick (an alter ego for Sterne) who is dying in Tristram Shandy, and it is through his preoccupation with Yorick that Tristram focuses his anxieties about health and death. Matthews may have been thinking of Sentimental Journey, whose central character-narrator is Yorick. The novel is clearly an attempt to defeat time and death by rendering experience as vertical instead of linear and horizontal, and Sterne was dying when he wrote it. Several references in The Diary of an Invalid also indicate that Matthews had Smollett on his mind as he traveled. Matt Bramble in Humphrey Clinker journeys after health with a similar sense of its being a “wild goose chase.”

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Although The Diary of an Invalid ends with Matthews claiming to return with “amended health,” the text reveals no clear pattern of improvement over time. Instead, the author’s sense of comfort and improvement is nearly always posited as contingent on shifts in climate and reactions to scenery, which seem to change as regularly and frequently as day turns to night. If Matthews suffered while abroad, it was not for lack of medical attention. Near the conclusion of The Diary of an Invalid he notes a “farewell visit” to a “Dr. Thomas,” claiming that the physician’s “medical skill” and “friendly attentions” enabled his health to derive “the greatest benefit” (422). The accolade would carry more weight were it bolstered by illustrative episodes in the diary, but in fact Matthews’s text points again and again to his own resourcefulness in seeking medical care and undertaking therapeutic options. Diary entries foreground his own efforts to “summon” surgeons to his side when pain erupts and repeatedly reveal his control in deciding whether to follow medical advice. Of an excursion to Vesuvius one diary entry records: “My surgeon warned me against this ascent, but I was resolved to go. To leave Naples, without seeing Vesuvius, would be worse than to die at Naples, after seeing Vesuvius” (204). Similarly, when relatively early on in his travels he finds himself “very unwell” in Rome, he observes, “My surgeon attributes my illness to the water, which, he says, is very noxious here,” but continues by noting, “I believe it has more to do with the air, for it is more cold than ever I felt it in England, whatever the thermometer may say to the contrary” (55). The remarks point to the lack of authority that the surgeon’s diagnosis carries with Matthews, even as they reveal more subtly his playful and sometimes humorous awareness of his own obstreperous selfdetermination. Somewhat predictably, Matthews made use of his status as Englishman when the situation demanded. Complaining bitterly that in Venice he could not submit his own prescriptions to the local apothecary “without the assistance of a physician,” he wryly observes that he would have had to go “without my draught” if “my friend the Vice-Consul had not supplied me from the consular medicine-chest” (265). Supplementing the diary’s references to particular bouts of suffering and entries devoted to his interaction with surgeons are passages in which Matthews highlights a more general sense of himself as an invalid. His entry for 24 and 25 September 1817, for example, reads: “Jaunted about Lisbon by land and water carriage. To walk about the streets is scarcely possible for an invalid” (10). In a similar spirit he much later in his account complains of having to dine at a restaurant instead of a pension, noting that the former “to an invalid in winter-time is a serious inconvenience” (357). What makes Matthews’s self-identification as an invalid especially interesting is that

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such passages are surrounded, even subsumed, by many others that document an extraordinary level of energy and activity. Diary entries such as “April 2nd. Convalescence. Visited the opera for the first time” (209) or “15th. Convalescence.—Crawled to the Archbishop of Tarento’s” (193) abound, and far more entries record visits to museums, churches, and cathedrals, large and small, excursions to the country, inspections of local schools, mints, hospitals, convents and asylums, and a seemingly unending social schedule of dinners and dances, the pleasures of theater and ballet. Once in Switzerland, boating and riding expeditions supplemented carriage rides, as Matthews, like so many other Britishers abroad, sought out picturesque views “amidst the wild and savage recesses of the Alps” (318). Far from suggesting that his suffering was feigned, the coexistence of invalidism and tourism as paradigms for Matthews’s identity indicates how mutually constitutive they were for a relatively well connected visitor from Britain. This relationship becomes apparent when Matthews pays tribute in his diary to the power of foreign lands to revitalize the wearied spirit, as when he wrote, “11th. Emerged from the confinement of a sick room, to enjoy again the genial air of Rome. How delightful is the calm tranquillity of this fallen capital, after the din and clatter of Naples! There is something so soft and balmy in the air, that I feel every mouthful revive and invigorate me;—and it is now as warm as midsummer in England” (213). In representing travel as revivifying and invigorating, Matthews makes use of a theme that would escalate in popularity in the years that followed The Diary of an Invalid. James Buzard identifies the same set of ideas at the heart of Samuel Rogers’s work of 1830, Italy: A Poem, showing that in it Rogers implies that however disparate the motives of various British travelers, they share the need “to revivify themselves, to recover that direct and joyous sense of life which their routine existence at home has nearly extinguished” (Buzard 101). The theme of invalidism as tourism was reinforced in a different way through Matthews’s obsessive note taking and analysis of minute differences in climate, not simply between nations or regions, but also between cities and even between different sites within a city. Often observations about climate are linked explicitly to the needs of the invalid tourist, as when in Naples he writes, “The weather is beyond measure severe and trying:— with a hot sun, there is a winter wind of the most piercing bitterness. A pulmonary invalid had better avoid Naples at any time, but certainly during the winter, unless he wish to illustrate the proverb, ‘Vedi Napoli e po’ mori’” (175). Much later in his diary, Matthews concludes that “Pisa is the very best place on the continent during the winter for complaints of the chest” and that

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“Nice, of which I speak from good authority, is perhaps the very worst” (358). Although the attention to climate at times borders on the obsessive, his ironic voice rescues him from the charge of endowing particular climates with unrealistic curative power. A March 1818 diary entry, for example, reads: “14th. Aegri Somnia—If a man be tired of the slow lingering progress of consumption, let him repair to Naples; and the dénouement will be much more rapid. The sirocco wind, which has been blowing for six days, continues with the same violence” (192). Matthews’s tone here is one that pervades other passages in The Diary of an Invalid, particularly those in which he reflects on the ideal of a search for health: The more I see of Italy, the more I doubt whether it be worth while for an invalid to encounter the fatigues of so long a journey, for the sake of any advantages to be found in it, in respect of climate, during the winter. To come to Italy, with the hope of escaping the winter, is a grievous mistake. This might be done by alternately changing your hemisphere, but in Europe it is impossible; and I believe that Devonshire, after all, may be the best place for an invalid during that season. (68)

Like the invalids who opted for water spas within Britain both to avoid the imagined hardships of foreign travel and to express allegiance to their nation, Matthews’s advice seems driven by dual motives. As significant is his tone, which here is captured by “grievous mistake,” a phrase that evokes far less condemnation than, for example, Dr. Burgess’s charge that invalids abroad exhibit “blind credulity.” Matthews is not simply recommending that health seekers limit their searches to places nearer home and give Devonshire its due; he is also pleading, if only implicitly, for understanding of their circumstances. He reserved his harshest criticism for himself, as when he paused near his narrative’s beginning to reflect, “I begin to suspect that all I shall gain by my voyage will be the conviction that a man who travels so far from home, in pursuit of health, travels on a fool’s errand. The crosses he must meet on his road will do him more injury, than he can hope to compensate by any change of climate” (30). However self-reflexive and selfaware Matthews reveals himself in The Diary of an Invalid, the work exposes a fundamental ambivalence experienced throughout his journey. All the bravado and irony cannot mask the deeply felt yearning for relief and equally deep sense of hopelessness that both motivated and plagued his journey. “To me, whose object in life seems unhappily confined to the task

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of killing time —till time shall kill me —no mode of travelling could be better suited,” he reflects as he journeys by buggy from Rome to Florence (233). He concludes, “But time is a sad antagonist to contend against; kill him as you may, day after day, you find him up again fresh and revived— more pertinacious than Sinbad’s old man—to renew the battle with you in the morning” (233). The emotive significance of Matthews’s doomed quest for rejuvenation is perhaps nowhere so evident as when he records a random encounter with some old friends and schoolfellows while in Rome. His diary entry includes the following thought: “What a delightful thing it is to laugh and talk over the almost forgotten days of boyhood; when all was fun and frolic. For a moment, one escapes from the present to the past, and becomes a boy over again” (217). Reminiscent of the ideal invoked by Bulwer-Lytton and his fellow water spa clientele, Matthews’s momentary paean to boyhood contrasts sharply with another image that frequents his travel account—that of the invalid amid the ruins. Matthews’s ruminations on Pompeii exemplify well a scene enacted at several other points in the diary: “So much for Pompeii:— I lingered amongst its ruins till the close of evening; and have seldom passed a day with feelings of interest so strongly excited, or with impressions of the transient nature of all human possessions so strongly enforced, as by the solemn solitudes of this resuscitated town” (172). The ruins of Pompeii were standard fare for the nineteenth-century tourist, as much a required destination as, say, Ann Radcliffe’s The Italian was required reading. Analyzing the significance of the motif of stillness that permeates the period’s travel literature, James Buzard describes “luminous moments” in which “the traveller is alone to savour a place’s poignant or powerful reverberations of beauty, sublimity, or significance” and the power of ruins to convey a kind of “undifferentiated ‘long ago’” (177–78). Although Matthews describes himself in this episode, as in others, as having been made strangely alive by his experience of the ruins, the passage’s confused dynamics of resuscitation and closure, the transient and the lingering, ultimately project a sense of idle inertia and stasis akin to that reflected in his ruminations on killing time “till time shall kill [him]” (233). If Pompeii stands for “the city as ruin,” Matthews uses the scene to evoke a sense of himself as a kind of human “ruin,” the person who once was having been displaced by the invalid who now is. Such is not, of course, the tone conveyed at the end of The Diary of an Invalid, when Matthews heads home, if not triumphantly recovered, at least with “amended health” and “brighter prospects.” His mood at this juncture was no doubt lightened because his

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tour, if not his search for health, was over, and after spending almost two years away, he could look forward with pleasure to the familiar routines of home life and the supposed moral certainties of English culture. Matthews was not alone in his discontent with a life of wandering, however advantageous to his health, nor was he the last to express such misgivings. Several decades later in the century, in works such as Wanderings in Search of Health, San Remo as a Winter Residence, and Searches for Summer, invalid authors continued to explore the advantages to an invalid of life abroad even as they evoked nostalgia for lives left behind. W. B. Aspinall, author of San Remo as a Winter Residence, a work identified only as “By an Invalid,” directs his observations to those fellow sufferers who may “unhappily” be “obliged to leave their own firesides in search of health” (127). Lord Albert Denison writes of returning to England at the end of his “wanderings” with “all the speed that steam and horses could enable me to make” (319). C. Home Douglas satisfied his own nostalgic yearnings for home in still another way, appending to his travel book a section titled “French Character,” in which he compares the French to “a nation of spoilt children, unable to acquiesce in the impossibility of every one having his own way” (188). In these works, nostalgia operates to solidify readers’ appreciation for the comforts and moral certainty that England embodies and signifies. These works followed standards set by Henry Matthews in other ways as well. Much like Matthews, Douglas sought rhetorically to protect himself from charges of idealism or naïveté by expressing skepticism about the possibility of cure. He encourages fellow invalids to rely not on the medical profession but on themselves to make sound judgments about their health, and his advice to fellow invalids in this respect is rendered with moral fervor. “The greatest error of all,” he warns, would be “in supposing that for the cure or mitigation of disease you are to look mainly to medical science, instead of to your own observation, self-candour, and self-control” (5). In a similar spirit, W. B. Aspinall advises his invalid readers to exercise caution and avoid fatigue and “too much excitement” during their travels. He adds, “Now that it is too late, I fruitlessly and bitterly regret not having followed this plan myself ” (114 –15). The tourist identity inflects these narratives in ways similar to those expressed in The Diary of an Invalid as well. Aspinall, for example, prefaces his book with an acknowledgment that his journey was “a route too well known to require comment” and that he seeks instead to restrict himself to discussion of those experiences most likely to benefit “delicate persons.” In Searches for Summer, C. Home Douglas bemoans the exertions of sightsee-

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ing, writing that “there is probably no human occupation more incompatible with health-seeking” (10 –11). “To plunge out of burning sunshine into an ice-cold cathedral is enough to give even a strong man cold; to an invalid it may be, and often is, fatal,” he warns (11). “Toil[ing] under a broiling sun” to get to Arpino, Lord Albert Denison writes, “How I suffered through my anxiety to see it; I could count the beatings of my heart as I laboured up to it, though I had a donkey to help me” (266). If the search for health brought with it the stigma of tourism, the invalid’s agenda and unique claim to “philanthropic motives,” to use Aspinall’s own phrase, could be invoked to offset that stigma. Acknowledging that “it may be held presumptuous on the part of a non-medical man to speak on questions of health,” Douglas claimed that his “extensive observation of invalids and their ways abroad” compelled him to expose the “very grave errors generally fallen into” (5). Returning home at the end of a search for health, however successful, provided an additional incentive to grin and bear with the representational challenges of having journeyed along a “beaten track.” Douglas is positively ebullient at the end of Searches for Summer, praising the Mediterranean climes for being “the means by which [his] wife has risen from the condition of prostrate invalidism to one of comparative health and strength” and expressing his hope that his readers, whether “Britons or Americans, or from whatever quarter of the globe they come” will experience similar rewards (184). Lord Albert Denison invokes national affiliation as well, reminding his readers at a key point near the conclusion of Wanderings in Search of Health: “The time that I had allotted to myself for an absence from England, was now nearly expired, and I had to hasten homewards” (302). However prolonged or unfulfilled their searches for health, these invalid authors were in some respects always homeward bound, and this posture inevitably helped to direct the sick role they adopted in their narratives. For other invalids, however, the search for health was less an experience of tourism, a matter of temporary wandering, than a relocation, which—as the experiences of John Addington Symonds and Robert Louis Stevenson reveal—introduced new possibilities and problems for negotiating the relation between one’s invalidism and one’s national identity. “In Our Mountain Prison”: Invalids and the Alps In December 1889 John Addington Symonds published a remarkable essay titled “A Page of My Life” in the Fortnightly Review. In the essay, he describes his experiences at the Swiss resort of Davos-Platz. Reprinting the

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essay a few years later in Our Life in the Highlands, written with his daughter, Symonds explains that it was composed at the request of the Fortnightly Review’s editor, who evidently had asked for “some notion of the conditions under which [his] life and work had been conducted since [he] was obliged to settle at Davos” (212). Symonds complied with the request but prefaced his representation of what he called “specimen days” with an explanation of how he ended up in Davos in the first place. The passage is worth quoting in its entirety: Twelve years ago I came to Davos, broken down in health, and with a poor prospect of being able to prolong my days upon this earth. I did not mean to abide here, but having regained a little strength, I hoped to pass the winter in a Nile boat. The cure of lung disease by Alpine air and sun and cold was hardly known in England at that time. When I found my health improve beyond all expectation, the desire to remain where I was, to let well alone, and to avoid that fatiguing journey to Cairo, came over me. Slung in my hammock among the fir-trees of the forest, watching the August sunlight slant athwart the branches, the squirrels leap from bough to bough above my head, it seemed to me that life itself would not be worth living at the price of perpetual travelling in search of health. I was thirty-six years of age; and, reviewing the twenty-three years which had elapsed since I went to Harrow as a boy of thirteen, I found that I had never spent more than three months in one place. At all hazards I resolved to put an end to these peregrinations, looked the future calmly in the face, and wrote twenty-two sonnets on “The Thought of Death.” Then I informed my good and famous physician in London that I meant to disobey his orders and to shut myself up for the next several months in this snow-bound valley. He replied that “if I liked to leave my vile body to the Davos doctors, that was my affair; he had warned me.” In the following spring I composed an article on my experience, which was printed in a number of the Fortnightly Review, and which contributed something, perhaps, to the foundation of the English colony at Davos-Platz. (212–13)

The passage succinctly establishes nearly all the thematic tensions crucial to Symonds’s writing about his identity as an invalid abroad. While the sardonic references to his interactions with his London physician and the concomitant emphasis on his own resolution convey the strength of his self-determination, he provides details that simultaneously indicate the haphazardness and chance at play in the decision making that landed him at

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Davos.11 He writes of the sense of resignation that prompted him to give up a search for health, dramatically suggesting that in doing so he had also to face death head on, but the tone of resignation is clearly undercut by the passage’s equally compelling emphasis on the literary productivity ostensibly promoted by the situation. Indeed, as “A Page of My Life” continues, Symonds observes that while in Davos he “worked incessantly at literature —publishing more than twenty volumes, besides writing a large amount of miscellaneous matter, and three volumes which still remain inedited [sic]” (213–14). Perhaps most significant, Symonds posits the Harrow experience as a kind of reference point for his ill health; while refraining from the explanatory detail provided in the Memoirs, he implicates a period indelibly associated with his passage into manhood with his current identity, at thirty-six, as an invalid, implying that travel has interrupted that passage. Davos has enabled him, he claims, to achieve a perspective on his past that hitherto had eluded him. Much as his Memoirs would serve a purifying purpose, through their generic affiliation with the confessional mode, so too did his stint in the “world of whiteness” that was Davos. Symonds’s self-declared decision “to shut [himself ] up” in the “snow-bound valley” resonates because it evokes the hidden, more psychological impulses driving what was also a very public gesture in support of the invalid life abroad (as suggested by his closing reference to what would be the first of a series of Fortnightly Review essays).12 Symonds’s experience of being an invalid abroad was thus distinctively different from that of the invalid whose search for health was conducted as a kind of grand tour. Ensconcing himself in the Swiss Alps, and creating there with his family a veritable home away from home, he became instead an expatriate invalid. Not only was he inevitably challenged to adapt to the foreign culture more than would a traditional tourist, he was also simultaneously deprived and relieved of the mind-set that comes when one thinks of one’s journey as temporary. As Symonds’s reference to the “English colony” at Davos suggests, he was far from alone in the mountain resort. Although an expatriate of sorts, he could also surround himself with his fellow 11. Margaret Vaughan’s preface to the second edition similarly stresses the haphazard, noting how “it happened that my father’s sister, Mrs. T. H. Green, and her husband were spending some weeks there” and describing the “variety of accidents [that] delayed [them] on [their] journey” (xi). 12. The rhetoric here was not unique to Symonds, however. Robert Louis Stevenson’s biographer, Frank McLynn, reports that the association of Davos with “a ‘closed universe’ or an island of the damned was reinforced by consumptive shopkeepers and tubercular hoteliers” (187).

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Figure 14. “Robert Louis Stevenson,” by Harry Furniss. Courtesy of the National Portrait Gallery, London.

English people and identify with the subculture of the English in Davos when it suited him. Symonds was joined in his periodical campaign to represent invalid life in the Alps by his friend and fellow intellectual Robert Louis Stevenson, who wrote autobiographical essays about his experiences abroad for Macmillan’s Magazine and the Pall Mall Gazette (fig. 14). Late in the year 1880, and soon after having been diagnosed as consumptive, Stevenson traveled with his family to Davos. There he would have access to a physician thought of as an expert in consumptive disorders, Dr. Karl Ruedi, and he would meet up with Symonds, who had arrived some three years earlier.13 Writing at this time, both men correctly saw themselves as in the vanguard of medical fashion. Stevenson begins “Health and Mountains,” the first of a series of Pall Mall Gazette essays, with the acknowledgment that “there has come a change in medical opinion, and a change has followed in the lives of sick folk” (457). Symonds’s first Fortnightly Review essay about Alpine life begins similarly with the observation that while “it has long been acknowledged that high Alpine air in summer is beneficial to people suffering from lung troubles . . . only of late years, and in one locality, has the experiment of a winter residence at a considerable elevation above the sea been made” 13. Just whether and when Stevenson was diagnosed with consumption is still a matter of some debate. See McLynn 171–72.

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(1). Whereas Henry Matthews and other invalid tourists who followed in his footsteps sought to legitimize themselves by openly expressing skepticism about medicine’s ability to link travel to recovery, Symonds and Stevenson reflect in different ways how far their lives have been directed by medical understanding. That Stevenson and Symonds both felt compelled to position their essays in terms of current medical fashion underscores the role that patient testimonials played in legitimizing medical science.14 At the time they began their treatment stints in Davos, the tubercule bacillus had not yet been discovered (it would be identified just a few years later, in 1882, by the German microbiologist Robert Koch), but some medical opinion had indeed shifted, as both writers suggest, to favor certain wintry climates as most efficacious in treating consumption.15 Because at least until the late 1840s consumption was thought, despite existing medical evidence to the contrary, to be a disease of those who lived in cold climates, there was naturally a certain skepticism when consumptives began later in the century to be enticed to spend their winters in frigid climes. Although himself an advocate for the kind of treatment regimen promoted at Davos, Robert Louis Stevenson barely masks a sense of doubt when he observes in “Health and Mountains” that “the invalid is now asked to lodge on wintry Alps; a ruder air shall medicine him; the demon of cold is no longer to be fled from, but bearded in his den” (458). More to the point, Symonds remarks in “Davos in Winter” that accustomed as we are to think that warmth is essential to the satisfactory treatment of pulmonary complaints, it requires no little courage to face the severity of winter in an Alpine valley, where the snow lies for seven months, and where the thermometer frequently falls to ten or fifteen degrees Fahrenheit below Zero. Nor is it easy, by any stretch of the imagination, to realise the fact that, in spite of this intense cold, the most sensitive invalids can drive in open sledges with impunity, expose themselves without risk to falling snow through hours of exercise, or sit upon their bedroom balconies, basking in a hot sun, with the world all white around them, and a spiky row of icicles above their heads. (74) 14. Patient testimonials were crucial to medical advertisement as well, and the market for quack medicines could not have succeeded without them. Chapter 4 explores still other ways that patient testimonials were inevitably tinged with overtones of the fraudulent. 15. Although Koch developed the tuberculin test, a major diagnostic advancement, effective drugs would not be developed until the twentieth century. For an interesting discussion of standard and alternative histories of tuberculosis, see Georgina D. Feldberg’s Disease and Class: Tuberculosis and the Shaping of Modern North American Society. She makes the important distinction between Koch’s elucidation of the etiological role of microbes and medicine’s often ambivalent response (4).

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Symonds may be accused of just a bit of exaggeration in his portrayal of the invalid’s winter wonderland, for in fact most invalids had had a few years to begin their adjustment to the idea by reading the many testimonies to the cold that were flowing across the Atlantic from the United States. Many a British invalid would first have learned about the value of cold air for consumptive complaints while reading about life in the high altitudes of Colorado. Climatotherapy and westward expansion worked together in the early 1870s to help publicize the attractions to invalids of life in newly established territories of the western United States. The pure air, “bracing” cold, and dry climate of the health resort of Colorado Springs were claimed to work wonders, particularly for the consumptive clientele. Rocky Mountains health resorts were widely touted in Britain, with physicians and travelers alike testifying to the area’s medicinal value. Charles Kingsley’s daughter Rose, for example, visited Colorado Springs late in 1871, and in South by West: Or, Winter in the Rocky Mountains and Spring in Mexico she includes what Sheila Rothman sardonically describes as “the required anecdote”: “One invalid whom I happened to know came out in the summer of 1871 apparently dying of consumption, obliged to be moved in an invalid carriage. In the spring of 1872 we wished him good sport as he started on foot for a week’s shooting and camping in the mountains!” (qtd. in Rothman 143). With a similar spirit of unbridled optimism Iza Duffus Harry in Between Two Oceans: Or, Sketches of American Travel (1884) describes Colorado Springs as “a veritable Eden for consumptive invalids” (231). Articles such as “Life in the Altitudes: Colorado’s Health Plateau,” “Colorado for Invalids,” and “The Consumptive’s Chances in Colorado” appeared throughout the last quarter of the century, and the news of America’s version of the health resort quickly spread overseas. Although tuberculosis sanatoriums were started in Germany in the 1860s and in upstate New York in the 1870s, most well-to-do consumptives were still inclined to travel to established health resorts such as Colorado Springs. British invalids clearly paid close attention to the literature extolling the virtues of the American West, but most were, like Robert Louis Stevenson, of the mind that “it is a far cry to the Rocky Mountains” (“Health and Mountains” 459) and were more inclined to seek out health stations closer to home. The Swiss village of Davos-Platz was relatively accessible and had an equally compelling, if emerging, reputation. At the end of his essay “Davos in Winter,” John Addington Symonds refers his readers not only to four German works on the climatic qualities of the Swiss health station but also to two letters in the Lancet written by Dr. Clifford Allbutt and to

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“the little anonymous publication entitled Davos-Platz, A New Swiss Retreat for Invalids and Tourists” (86–87). When in 1887 the physician Clinton Wagner published an article titled “Colorado Springs and Davos-Platz as Winter Health Resorts, Compared,” he put into print an opinion that had percolated through the invalid community for a decade.16 Even though both Stevenson and Symonds wrote about Davos’s medical reputation, it would be misleading to suggest that they were exclusively motivated by the desire to disseminate medical opinion, though this was certainly part of Symonds’s goal. Although he envisioned “Davos in Winter” as helpful to invalid readers because it was written “without any scientific pretense or display of theory” (74), he confidently prefaces a lengthy description of “the method of cure” with historical information on its settlement and background on its “discovery” by a district physician whose work was soon after picked up by German physicians. “It speaks volumes for the place, and for the genuine nature of the cure effects there,” Symonds notes, “that it has grown up gradually in this short space of time, without the attraction of mineral waters or fascinating specialties of treatment; without the intervention of speculative capitalists, intent on floating a new watering place; without the charms of a luxurious climate, and without the patronage of royal or illustrious names” (76). He offers, in other words, not simply a testimony to Davos’s curative potential, but also a critique of a more touristy type of health resorts and those who subsidize them. Nevertheless, when at the end of his essay he writes that “there is no conveying the charm of immaterial, aerial, lucid beauty, the feeling of purity and aloofness from sordid things, conveyed by the fine touch on all our sense of light, colour, form, and air, and motion, and rare tinkling sound,” one senses just how far his essay has moved in a different direction, shifting from the ethnographic and scientific to the evocative, from the tangible to the intangible, and focusing less on benefits to body than on impact on mind (86). The essays that Robert Louis Stevenson based on his experiences as an invalid were, even more than Symonds’s, impressionistic rather than documentary in orientation, and in this sense they stand apart from travel texts (like those by Matthews, Denison, Aspinall, and others) that positioned themselves as guidebooks or chronicles of the invalid tourist’s movements between sites and cities. Unlike these other authors, both Symonds and Stevenson already had reputations as literary men when they relocated to Davos. They were thus in a very different position than, say, W. B. Aspinall,

16. Wagner’s article was published in New York Medical Record 32 (29 Oct. 1887).

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who concludes San Remo as a Winter Residence with the remark: “I am no book maker, but have written simply and solely with the hope of benefiting fellow invalids” (127). Symonds and Stevenson brought works in progress with them to Davos, inaugurated other projects while there, and actively maintained their professional ties throughout their stays. Although they identified with the community or “colony” of invalids who populated Davos, that identity did not displace their sense of themselves as well-established authors. Moreover, for both Symonds and Stevenson, as for many British people, the Alps functioned as a kind of symbolic boundary between the masculine North and the feminine South. Davos’s geographic position helped to ensure that writing produced from or about it would be markedly different from that originating in, for example, Mediterranean regions. Stevenson says as much when in the beginning of “Health and Mountains” he ruminates about the beauty and comfort of the Riviera and acknowledges, “Yet there was a latent shiver in the sunshine; you were not certain whether you were being wooed; and these mild shores would sometimes seem to you to be the shores of death. There was a lack of manly element; the air was not reactive; you might write bits of poetry and practise resignation, but you did not feel that here was a good spot to repair your tissue or regain your nerve” (457). Stevenson sets himself up here as a particular type of invalid, one whom he defines in contradistinction to the more passive (and feminized) invalid whose dominant posture is one of submission. An interesting inversion of domestic ideology surfaces as Stevenson pursues the analogy, arguing by essay’s end that the North not only cultivates the “manly” but also sequesters the pure. “From across storied and malarious Italy, a wind cunningly winds about the mountains and breaks, warm and unclean, upon our mountain valley,” he writes at the end of “Health and Mountains.” “Every nerve is set ajar; the conscience recognises, at a gust, a load of sins and negligences hitherto unknown; and the whole invalid world huddles into its private chambers, and silently recognises the empire of the Fohn” (462). Stevenson’s “invalid world” is notably less easy to identify than Symonds’s “English colony,” defined as it here not by nationality but by its posture of sequestration. Stevenson saw even more potential for invalid life in the Alps when he pondered the combined benefits of Colorado’s program of bracing air and physical activity: “The man can open the door; he can be up and doing; he can be a kind of a man after all and not merely an invalid” (“Health and Mountains” 458). His vision was reinforced in J. Weber’s Illustrated Europe:

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Davos Guide Book of 1880: “Davos demands qualities the very opposite of resigned sentimentalism in which too frequently the phthisical youth or maiden was encouraged. Here is no place for weak and despairing resignation; here you are not pusillanimously helped to die, but are required to enter into a hard struggle for life” (qtd. in Dubos and Dubos 177). Such rhetoric made demands not only on gendered associations of the masculine with the active, the feminine with the passive but also on the nineteenth-century Evangelical-inspired valorization of resignation in the face of suffering. It also makes clear the place of Switzerland and its health resorts within an emerging geographic imaginary. If by the early 1860s much of Switzerland was arguably “on the beaten track” of British tourists—thanks in part to the remarkable increase in the popularity of mountaineering—by the 1870s travel writing itself had been transformed in substantial ways, much of it affected by and emphasizing the values and modes of aestheticism. The shift of British travel books toward “impressionism and diegesis” was, James Buzard contends, a response to the barrage of handbooks and guidebooks whose “daunting detail” and “copious fact” made it virtually impossible for the travel writer to add anything new. Late-century travel writing, he notes, solidified a divide between the prosaic and the poetic: “Spurning direction-giving and description, travel-writers could, it appeared, continually renew their genre no matter how beaten the track or hackneyed the sights” (169). Both Stevenson and Symonds thought of themselves as well-seasoned travelers and in different ways sought to distance themselves from the stereotypical tourist. In his essays for Our Life in the Swiss Highlands Symonds found frequent occasion to bemoan the influx of “foreigners” as the wonders of Davos become increasingly well known. “I always wonder how long what boasts to be a ‘Luft kur-ort,’ or health resort, depending on the purity of air for its existence, will bear the strain of popularity and rapid increase,” he speculates midway through “A Page of My Life” (216–17). Coaching his invalid readers on how to experience the authentic and untrodden even in the well-worn paths of the Davos country, Stevenson wrote, “You may drive through a forest so disguised, the tongue-tied torrent struggling silently in the cleft of the ravine, and all still except the jingle of sleigh-bells, and you shall fancy yourself in some untrodden northern territory—Lapland, Labrador, or Alaska” (“Davos in Winter” 466). Stevenson and Symonds are also similar in their attention to an invalid readership. When Symonds began writing about his experiences in the Swiss Highlands, he thought of himself as communicating important infor-

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mation to invalids at home; indeed, when he reflected in 1892 on “Davos in Winter,” originally written some thirteen years before, he pointed out that most of what was then new had become “the common property, not only of experts, but also of the general public” (20). Many of Stevenson’s essays are addressed more overtly, and seemingly exclusively, to an invalid audience — the “all we sick folk” referred to in “Alpine Diversions” (469). He simultaneously instructs and pokes fun at these readers, as when in “Health and Mountains” he writes, “You may perhaps be an invalid who likes to make bad verses as he walks abroad. Alas! no muse will suffer this imminence of interruption—and at the second stampede of jodellers you find your modest inspiration fled” (“Davos in Winter” 465). More important than their kindred stylistic features are the thematic similarities that characterize Symonds’s and Stevenson’s representations of life for the invalid in the Alps. Both essayists devote a substantial portion of their work to describing the physical activities the invalid typically engages in, stressing the pleasure of bodily movement and exercise even while acknowledging the inevitable limitations imposed by frail health. Contrasting the “miasma of the sick-room” to the “pure, rare air of the open mountains” (458), in “Health and Mountains” Stevenson depicts invalids “marching to and fro upon the snowy road, or skating on the ice-rinks” (459), and he concludes the essay “Alpine Diversions” with an evocative description of nighttime tobogganing, the mobility of the invalids juxtaposed to descriptive scenes of the frozen and inert white world that encloses them. Scenes similarly devoted to representing the pleasures and restorative powers of motion are enacted in Symonds’s “Winter Nights at Davos,” which describes the “almost savage swiftness” of a toboggan ride (448). With an emphasis on physical activity and prowess that echoes “muscular Christianity,” these and similar scenes in both men’s writing suggest that no small part of the appeal of Alpine life lay in male invalids’ ability to partake in dimensions of life from which they might otherwise be excluded. Ideals of English manhood become achievable in the Swiss open air. In “A Page of My Life,” Symonds asks his readers to “behold us starting, then, for our thirteen hours’ sleighing journey, wrapped from head to foot in furs!” (Symonds and Symonds 216). Physical activity is represented as both exacting and fortifying; it is the key to a cure, and Symonds warns of the necessity of strict adherence to the regimen and, curiously, of the “moral energy” exacted by the corollary “ascetic life” (“Davos in Winter” 9). One can sense in Symonds’s descriptions just how much a “health resort” like Davos in fact had in common with the sanatoriums that were at that same moment springing up in Europe and in America, for both clearly relied on a regime

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of fresh air and exercise.17 Marveling at the increase in his ability to “take exercise” while at Davos, Symonds claimed to be transformed from being just able “to climb two pairs of stairs without the greatest discomfort” to being able “to walk 1,000 feet uphill without pain and without fear of hemorrhage” (“Davos in Winter” 77). He posits an experience much like that of his more robust fellow countrymen who ventured to the Alps to mountaineer; like them, physical exertion “supplies a sense of conquest out of which identity emerges” (Haley 254). Robert Louis Stevenson, too, extolled the virtues of the “vivifying change” brought about by mountain scenery. In “The Stimulation of the Alps,” he observes that “a tableful of invalids comes, in a month or two, to resemble a tableful of hunters” (474). Less concerned than Symonds with publicizing the curative potential of Davos, however, he more often highlights the limitations on physical activity the invalid experiences, the privations of the sick role compared with the opportunities the healthy have at their doorsteps. “Davos in Winter,” for example, begins with the complaint that in a mountain valley “the health seeker is rigidly confined,” for “there are for him no cross cuts over the field, no following of streams, no unguiding rambles in the wood. His walks are cut and dry. In five or six different directions he can push as far, and no farther, than his strength permits” (463). A similar note of deprivation surfaces in “The Stimulation of the Alps” when he writes of the “delicate exhilaration” felt by the invalid as he contemplates the “enchanted landscape” but notes, in a remark laden with overtones of Romantic sensibility, that it is “greater than can be said in prose, almost greater than an invalid can bear” (476). The heightened significance that both Symonds and Stevenson attach to physical activity is partly explained by their shared sense of the frustration and challenge posed by the monotony they believed to be endemic to the Alps. Both men found ample opportunity at various points in their travel writing to describe and lament the seemingly unchanging landscape and atmosphere of their “winter-world” (Symonds, “Davos in Winter” 17). For Symonds, monotony was a feature of the cure itself: “The mechanic pacings to and fro, which are a condition of the cure, become irksome; and the discontented invalid is apt to sigh for the blue Mediterranean and the skies he remembers on a sunny Riviera Shore” (“Davos in Winter” 9). Stevenson confidently began one travel essay with the declaration that “there will be no 17. Although Davos led the development of Swiss Alpine tuberculosis resorts, its program, according to F. B. Smith, was more conservative than others, for “Swiss phthisics remained more skeptical about the curing powers of dry cold air at high altitudes. Its chalets were unventilated” (99).

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lack of diversion in an Alpine sanitarium” and promised his invalid readers “all manner of variety in the nature of the tracks” they would find on their daily walks (“Alpine Diversions” 468, 472); but his optimism was shortlived, for he demonstrated significantly less tolerance for the monotony than did Symonds. He mournfully looks on as “wandering artists” come and go from the Davos community “while all we sick folk still simmer in our mountain prison” (469). Although in “Ordered South” Stevenson proclaims for the invalid abroad a certain satisfaction, writing that “his narrow round becomes pleasant and familiar to him as the cell to a contented prisoner” (72), the enclosure of Davos felt very different. In “Alpine Diversions” he credits the “invariable sameness of the snows and frosty air” with making something as simple as a flower “surprise you like an adventure” (470). The Mountains are about you like a trap,” he complains in “Davos in Winter,” observing that “you cannot foot it up a hillside and behold the sea as a great plain, but live in holes and corners, and can change only one for another” (467). In Stevenson’s mind, the Davos cure forced the invalid to be “an idler among idlers” (“Health and Mountains” 459); for him there were precious few opportunities for “an active life and an honest livelihood” that sick men could enjoy in Colorado. However different their attitudes toward the monotony of the invalid’s life in the Alps or their ability to withstand it, Symonds and Stevenson developed remarkably similar responses to it in their essays. For both, the routine of daily existence and the seemingly unchanging backdrop of the snowcovered mountains—what Symonds called “a world of whiteness”—became a catalyst for experiencing aesthetic pleasure. Well before either man had relocated to Davos, British critics had begun to explore the connections. The author of “Aesthetics among the Alps,” a Blackwood’s Edinburgh Magazine essay of 1857, argued that “To the Alpine powers of nature, we require the application of the Alpine power of mind; and then may perchance arise a third and equal power—the power of Art,—an art which shall mould mountains into a satisfying expression of man’s aspirations and yearning towards the boundless” (266). Stevenson brought to the Alps considerable thought on how invalids in particular experience aesthetic pleasure; in “Ordered South” he writes that “if it is only rarely that anything penetrates vividly into his numbed spirit, yet, when anything does, it brings with it a joy that is all the more poignant for its very rarity” (70). “For the pleasure we take in beautiful nature is essentially capricious,” he goes on to observe. “It comes sometimes when we least look for it; and sometimes, when we expect it most certainly, it leaves us to gape joylessly for days together, in the very home-land of the beautiful” (70). Much as he found to complain about

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while he lived the invalid life abroad, Davos did become just such a “homeland of the beautiful,” and his phrase is subtly suggestive of how deeply he identified with a nation other than his own. In “The Stimulation of the Alps” he writes of being made to feel “stingingly alive” by the rare, cold air and “blinding light” of Alpine winters (475). Similar rhetoric pervades “Alpine Diversions,” which concludes with a reference to “a night made luminous with stars and snow” that he claims “teaches the pulse an unaccustomed tune and adds a new excitement to the life of man upon his planet” (473). In his Memoirs Symonds explicitly correlates what he calls a return of his “sense of beauty” with the onset of his physical recovery (260), and his essays about invalid life in Davos accordingly represent the “sense of beauty” in action. Pondering the effect of light on the “snow world,” for example, Symonds makes use of the language of the aesthete. “Scale is annihilated,” he writes, concluding that “the whole landscape . . . is transfigured—lifted high up out of commonplaceness” (“Davos in Winter” 86). He makes the link between monotony and aesthetic pleasure even more explicit when he writes in “Winter Nights at Davos: Leaves from the Diary of an Invalid,” “Could the human race be acclimatised to this monotony, we say, perhaps emotion would be rarer, yet more poignant, suspended brooding on itself, and wakening by flashes to a quintessential mood” (447). With their references to “man upon his planet” and “the human race,” Stevenson and Symonds seem to want to broaden the significance of their experiences to include all of humanity, to imbue the invalid’s perspective with ontological significance. Both men come back repeatedly throughout their work to the distinctiveness of the invalid’s experiences and perspective. In “The Stimulation of the Alps,” Stevenson argues that aesthetic pleasure, though ultimately transient, is “more than worth more permanent improvement,” concluding that the “dream of health is perfect while it lasts; and if, in trying to realise it, you speedily wear out the dear hallucination, still every day, and many times a day, you are conscious of a strength you scarce possess, and a delight in living as merry as it proves to be transient” (476). If for Symonds monotony was ultimately not as stressful to endure as it was for Stevenson, it was perhaps because he found so much about his life in the Highlands that was more permanently liberating. Remembering the life she shared with her father in Davos, Symonds’s daughter Margaret Vaughan wrote that “with whatever wreckage of the past it had been bought” their life “was certainly one of health and happiness to [her] father and to all who shared it with him” (Symonds and Symonds, xvi). In a letter from Davos he wrote of the mountains: “Of course, they coop one up more than hedges and

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copses, but they do not coop the spirit up” (Symonds and Symonds, xiii–xiv). His remark makes apparent how much his perception of his experiences in Switzerland was shaped by a corollary awareness of the restrictedness of English social life. In this sense, in Symonds’s travel narratives “England” functions just as powerfully, if in a quite opposite way, as in works like Matthews’s Diary of an Invalid. In “Davos in Winter” Symonds links the beauty of the country to “the feeling of purity and aloofness from sordid things” (86), a reference that resonates all the more when viewed in juxtaposition to the relentless scrutiny in the Memoirs of what he believed to be his own “sordid” nature. In fact, even that more private text testifies to the well-being he associated with his years in Davos: “Whatever happens,” he wrote, “I shall remember that these years of my chequered, confused and morally perturbed existence have been the best, the healthiest and the most active of the whole” (259). John Addington Symonds and Robert Louis Stevenson had much in common, but they understood health itself in very different terms. Long before he arrived in Davos, Symonds had identified multiple sources for his physical and psychological distress, and the very fact that these sources combined to render him an invalid seems to have made him more receptive to relief. In Symonds’s writing on Davos, two views of health emerge, each significant in the agency ascribed to the invalid. On one level, he understood health in a traditional medical sense, and by providing his invalid readers with information and practical advice he offered a set of options and implied the possibility of self-determination. On another level, Symonds sought in his writings to come to terms with what Bruce Haley calls a “higher health,” which provides the “feeling of being spiritually as well as physically at home among things” (255). Operating only implicitly in his public writing on Davos, this second view of health is addressed openly in his Memoirs, which associates England with the “sense of law and instincts of convention” (254) that force upon him a sense of himself as “incurable.” However much he remained “loyal” to those laws and conventions by seeing them as such, Symonds nonetheless took on an expatriate status in Switzerland, his allegiances shifting as he contemplated the social relations he believed to be possible in, and even fostered by, that society. Rictor Norton has noted that “with no pressing need to be respectable, [Symonds] could live in an unconventional manner” (6). Believing himself motivated by fundamentally democratic impulses, he established intimate friendships with many Swiss peasants. In his Memoirs he proudly writes, “Now I count scores of men among my intimate acquaintances—peasants of every description, postillions, drivers, carters, conductors of the diligence, carpenters, doctors, par-

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sons, schoolmasters, porters in hotels, herdsmen on the alps, masons, hunters, woodmen, guides, hotelkeepers, shopkeeper, stableboys, artisans,” and he traveled openly with one of his lovers, Christian Buol (267).18 More important, Symonds believed these relationships had political import: “For a student and a man of letters what I learned from these sturdy children of nature has been invaluable. They have confirmed my belief in democracy, and proved to me that high thinking and loyal feeling can be combined with the plainest living” (Memoirs 268). In his published essays on Davos, Symonds predictably refrains from linking the health he acquired (or discovered) abroad to his sexual experiences and developing understanding of homosexuality as democratic, but he nevertheless projects an attitude about health that undeniably embraces the whole person and hence includes the sexual self. Stevenson was as concerned as Symonds with the whole person, mind and body, but his invalid persona enjoyed at best an ephemeral kind of health, experienced only in rare and fleeting moments of aesthetic pleasure. More often prey to languor and lassitude, he “simmered” in his “mountain prison,” language that conveys a far deeper sense of stasis than that implied by the notion of a health station. As distanced as Stevenson’s and Symonds’s perspectives seem from one other, they share (with each other and with the tradition of invalid travel writing more generally) an association of invalidism with inertia. In Symonds’s case, the association was enforced by his status as a person made expatriate not simply by his lungs but also by his sexual nature, for he was all too aware that in England he had access to neither the air nor the social freedom of life in Davos and so he was stuck, as it were, living abroad. For Stevenson, ill health led inevitably to “numbness of spirit,” a condition he compared to “premature old age” (“Ordered South” 71). “Like an enthusiast leading about with him a stolid, indifferent tourist,” he wrote, the invalid was forever “looking with all his eyes, and waiting for some return of the pleasure that he remembers in other days” (69). Stevenson’s version of the perpetual search for health evokes a sense of emotional stasis and captures well the sick role adopted by all who lived in what Charles Edwardes just a few years later would describe as “this air of exile” (206). 18. In A Community of One, Martin Danahay notes that the tendency of Romantic authors to sympathize and express “solidarity with marginalized people” enabled them to believe they were “profoundly isolated and separated from the broader social movements of the day” and to project in their writing “essential isolation, alienation, and loss of community” (17). Symonds’s catalog of “intimate acquaintances,” which achieves much the same effect, might be seen as a late-century version of this cult of the marginalized.

4

“SIN-SICK SOULS” Christian Invalids and the Literature of Consolation

Beloved, think it not strange concerning the fiery trial which is to try you, as though some strange thing happened unto you: but rejoice, inasmuch as ye are partakers of Christ’s sufferings; that, when his glory shall be revealed, ye may be glad also with exceeding joy. —1 Peter 4:12–13 To be strong in faith, and patient in hope, in a long and lingering sickness, is an example of more general use and ordinary application, than even the sublime heroism of the martyr. —Hannah More, Practical Piety But, above all, the invalid’s work is to pray. —M. Giles, Up the Hill Difficult

D

espite all the skepticism and caution that would characterize his other writing on life in Switzerland, Robert Louis Stevenson’s Pall Mall Gazette essay “Health and Mountains” is a remarkable testimony to the potential for renewal available to the invalid abroad. His spirited association of men and mountains with all that is robust nevertheless depends on a crucial assumption about other “sick folk.” Championing the opportunities for manly work and open air available to invalids in Colorado, Stevenson writes, “Resignation, the cowardice that apes a kind of courage and that lives in the very air of health resorts, is cast aside at a breath of such a prospect. The man can open the door; he can be up and do-

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ing; he can be a kind of man after all and not merely an invalid” (458). Many assumptions are embedded in Stevenson’s remarks, but among the most significant is his construct of a particular type of invalid who exists in passive opposition to an active “up and doing” man. In Stevenson’s imagination, invalidism entails compliance and acquiescence, a debilitating posture of submission inextricably bound to the feminine.1 Not all Victorians shared his sense of scorn. A very different attitude toward resignation surfaces in the many dozens of books, pamphlets, and tracts published during the period that extolled the merits of sickroom experience. As the anonymous author of The Cup of Consolation: Or, Bright Messages for the Sick Bed put it, “The invalid, who feels resignation to the Divine will the softest pillow for the weary head, can happily never forget the incomparably more valuable boon. Even in the loneliest sick-bed, the loneliest night-watch, whether that be in the home of luxury or in the garret of poverty, or in the mountain shieling, ‘the golden bowl’ of ‘everlasting consolation and good hope through grace’ can never be broken” (11). Far from indicating cowardice, the resignation embodied by this invalid signals a capacity for spiritual redemption, which here promises restoration and freedom from the bondage of class consciousness. Indeed, many invalids relished the opportunity to ponder and remark on affliction’s capacity to efface social distinctions. Anyone —child or adult, man or woman, wealthy or impoverished—might be subjected to the lessons of “the school of long affliction.” Within the sickroom they were sure to be taught what to value. As the author of The Solace of an Invalid wrote, “The attractions of pleasure, the glare of wealth, the splendour of power, lose much of their influence over the mind, when it is brought by misfortune and sorrow to regard them in their real nature, fleeting and unsubstantial forms, unworthy the eager pursuit of an immortal being; and we cease our immoderate desires to obtain them” (76). In this view, chronic suffering provides a ready-made escape from the competitive world of status seeking, the very world that invalids such as Charles Lamb, Edward Bulwer-Lytton, and the author of Confessions of a Hypochondriac found so debilitating. Illness, many nineteenth-century invalids argued, conferred on the sufferer a far more valuable form of status, the status that came with the price1. Stevenson’s attitude compares in interesting ways with a review of Frederic Townsend’s Fancies of a Whimsical Man, which was marketed as having been writing “by the author of Musings of an Invalid.” The reviewer wrote, “The invalid has laid aside his chamber negligee and come forth as quite a stout and eupeptic man.” The comments are reprinted on page 3 of “Books Published by John S. Taylor,” appended to Clouds and Sunshine.

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less opportunity to experience and exhibit grace.2 Robert Louis Stevenson may have associated the sickroom with an indelible taint of miasma that little compared to the bracing, open air of mountains, but many other nineteenth-century invalids found in it inspiration for a powerful and different kind of healing. They were a very different kind of “traveler” than Stevenson was, for they thought of themselves as pilgrims journeying to the “promised land” or, in related rhetoric, as “wanderers” brought home by God. As one of the poets excerpted in Fanny Henslowe’s Literary Gleanings by an Invalid effused, “The world’s a wilderness of woe, / And life a pilgrimage of pain!” (19). In a world largely without the promise of effective drugs for treating and curing disease and disorder, texts such as The Cup of Consolation, Literary Gleanings by an Invalid, and The Silent Comforter performed an important cultural service as resources for coping. Roy Porter and Dorothy Porter argue for the significance of values such as resignation, fortitude, and stoicism to our understanding of the patient’s experience in early Modern England (235–44). In doing so, they draw largely on excerpts from private diaries and letters. The significance of nineteenth-century consolation texts is that they were published and seemingly designed as tools to cultivate such values in their invalid readers. Books and tracts such as Jabez Burns’s Sermons: Designed for the Sick Room, Family Reading, and Village Worship, John Thornton’s A Companion for the Sick Chamber, Robert Brett’s Devotions for the Sick Room, and anonymous works such as The Solace of an Invalid, What Is It Today? Sunday Half-Hours with an Invalid, The Invalid’s Own Book, and Sunny Life of an Invalid were just a few of the many dozens of spiritual texts devoted to the enrichment of the Christian invalid’s character that poured forth from religious and independent presses and agencies in the nineteenth century, adding force to what Richard Altick calls a “century-long torrent of [religious] print” (English Common Reader 108). Aptly titled was the 1821 book Spiritual Recreations in the Chamber of Affliction: Or, Pious Meditations in Verse, for its author—named only as Eliza, but identified on the title page as having written the work “during a protracted illness of thirteen years”— emphasized through the term recreations the re-creation or reformation of her character. In many respects this literature intended for use in the sickroom can be seen as an inevitable outgrowth of Evangelicalism, which posited pain as “an 2. I borrow the phrase “exhibit grace” from Mary Fissell’s “The Disappearance of the Patient’s Narrative and the Invention of Hospital Medicine.” She argues that while a secular style of patient narrative dominated early modern medicine, Quakers and Methodists were exceptions in that they attributed meaning to illness in spiritual rather than medical terms (98).

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essential part of God’s order” and taught that suffering was not simply an inevitable feature of life but rather a God-ordained event for which to be grateful (Hilton 11). Taking note of the important variations in Evangelical attitudes toward suffering, Boyd Hilton summarizes, “Moderates regarded pain as part of God’s joyous plan for the moral redemption of mankind, while pre-millenarian extremists saw it as a sign that the thousand-year reign of felicity could not be long delayed” (17). “What both were trying to do,” he concludes, “was to reconcile the evil and suffering, which after 1789 were felt to dominate the world, with the continuing existence of a powerful and loving God” (17). Like Hilton, Lucy Bending notes the variations in the attitude adopted by the “Christian Church” in Britain toward the “problem” of pain and suffering. Noting that “its manifold meanings were pulled sharply this way and that by party and denominational allegiances, remaining unstable even within the boundaries of a single denomination” (6), she emphasizes the crucial difference between the “doctrinally sanctioned pains of Christianity” and the “pains of earthly existence” (7). For Edward Bulwer-Lytton, Robert Louis Stevenson, John Addington Symonds, and many others, the “pain of earthly existence” clearly was enough to contend with, but many of the invalids who wrote commonplace books concerned themselves with both kinds of pain and, in fact, sought to link one to the other. Evangelical discourse provided the mechanism for this linkage. Robin Gilmour locates the source of Evangelicalism’s widespread influence on intellectual and cultural discourse in its particular appeal to the sufferer. “Eighteenth-century Anglicanism had many real virtues,” he writes, “but its characteristic posture of sociable deism had little to offer the soul in extremis ” (72). Gilmour goes on to explain that “its God remained behind the clockwork universe of Newtonian physics; He could not be reached. But the suffering God of the Gospels could be, if the Christian was prepared to acknowledge the depravity of mankind and throw himself on the mercy of God promised in Christ’s atoning sacrifice” (72). Many invalids were more than willing to make this avowal, secure in the belief that doing so would help to ensure their salvation. In the sermonizing words of one author quoted by Fanny Henslowe in her collection, “Afflictions are messengers sent from heaven to wean us from indulging too much in the joys of this world” (160). Small wonder that the motif of expressing gratitude for one’s suffering is so dominant; as the author of Letters from a Sick Room wrote, “I am enabled not only to be grateful for the many blessings which brighten my path, but for the affliction itself. I look upon it as a scourge, sent to bring a wanderer home, and can acknowledge the justice of every successive stroke” (71).

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Writing that “it would . . . be difficult to overestimate the sway that the Evangelical reading of pain had over the Victorian representation of illness,” Miriam Bailin notes its coincidence with the mid-Victorian devotion to the care of the sick (Sickroom 10 –11). While books of spiritual consolation by invalids should be understood as a primary manifestation of that emphasis on care, they were far from uncomplicated texts, not least because many were also deliberately devised to be self-serving. Most included the selected contents not only because the material had consoled or brought solace to the invalid authors but because these authors believed the material could bring similar relief to their fellow sufferers. In this sense, the invalid-written commonplace book or consolation text functioned as a kind of self-help tool, designed to further the agency of the invalid reader. The literature of consolation borrowed extensively from established conventions of conduct books and commonplace books, two related kinds of texts with roots extending back to the Renaissance, which flourished from the late eighteenth century into the nineteenth. Although both points of origin are traditionally associated with women readers, male and female invalids alike compiled consolation texts for one another (Flint 94 –95). Like conduct books, they provided guidance, offering invalid readers spiritually inflected instruction on practical issues such as “On taking Physic” or “On Want of Sleep,” as well as on myriad less tangible dimensions of the sickroom experience, perhaps most especially how to acclimate to and make profitable the otherwise wearying and monotonous experience of the sickroom. “My pen has been the means of beguiling many a long hour of . . . ennui and uncomforts,” confessed the author of Outlines Selected from the Blotting Book of an Invalid (2). Much Christian literature for invalids borrowed even more obviously from the rhetorical and generic conventions of commonplace literature, with contents typically selected from the Bible, the Book of Common Prayer, and other devotional literature as well as from literary sources. Indeed, the hodgepodge nature of such texts is gently spoofed in A. B. Ward’s “Hospital Life,” which describes one patient as a “prig, who finds fault with whatever is done for him, who judges the texts upon his quilt offensive, and asks if the ‘silent comforter’ at the foot of the bed is ‘Catholic or Episcopal or anything, ’cos’ I’m Methodist and I won’t have it if it is’” (70). The patient is told, “‘Oh, no, that’s a little of everything ’cep’ Mormon’” (70). However varied their contents, commonplace books were believed to cultivate the intellectual life of their compilers (Flint 95); as practical, “useful” texts they necessarily conferred moral favor on the invalids who, whether by compiling or by consulting one, rendered their sickroom experience “profitable.” The material

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reproduced to be practiced by or beneficial to the invalid was often the same as what would be stitched into samplers—Bible verses, homilies, and moralizing epigrams designed to reinforce virtues such as piety, obedience, submission, and resignation. Invalid-written consolation texts that used the conventions of conduct and commonplace books thus provide a unique window on the experiences and assumptions of invalids. By their very nature, commonplace books were composed of material that the compiler used as guideposts for personal reference and self-development. Pointing inward in this way, they “signified the construction of a self through the mastery of a collection of materials” (Gray 63). Cumulatively, the collected materials commemorated particular stages of life —in the case of the books examined in this chapter, that “stage” was protracted suffering.3 I should emphasize that commonplace books belong traditionally to a genre of personal, private writing; though sometimes designed to be shared with friends and family, they were rarely published. The very existence of the many published commonplace-like books such as The Silent Comforter, The Solace of an Invalid, and The Invalid’s Own Book suggests that their invalid authors (or editors) both tapped into this kind of text and helped to generate a market. Moreover, their subject matter—the meaning of affliction, the necessity of resignation in the face of suffering, the virtue of patience, and so on—helped to secure and legitimize their place within the public domain. By extension, such texts helped to define the figure of the Christian invalid as the embodiment of particular values and attitudes. Some of the texts directed specifically to the needs of the sick were written by members of the clergy and others by lay men and women. As the title of Fanny Henslowe’s volume, Literary Gleanings by an Invalid, suggests, not all commonplace books by invalids were theological in orientation; nevertheless, the vast majority drew primarily from devotional literature for their contents. While these texts used their biblical and literary sources of understanding and comfort in different ways, they shared a sense of the invalid’s particular needs, strengths, and satisfactions. Indeed, the textual prominence of the implied readers of these commonplace books—chronic sufferers presumably consoled by the materials their fellow invalid has gathered—is one of this literature’s most distinguishing features. Providing their readers with the tools and encouragement to understand ill health as serving spiritual purpose, these texts helped to pro3. I benefit here from Janet Gray’s excellent article “Dora Greenwell’s Commonplace Book.” Gray situates her study within a theoretical framework that distinguishes between the functions of the souvenir and the functions of the collection, arguing that the two commingle in Greenwell’s commonplace book.

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duce a distinctive model of invalidism, one that oriented itself not around the allure of cure or the promise of reprieve but rather around the comforts of consolation, the virtues of resignation. Not surprisingly, the figure of the invalid generated within these texts—whether in the role of author or reader—brought different qualities to the sick role that inevitably helped to shape the broader societal interpretation of invalidism. This chapter examines representations of and attitudes toward invalidism inscribed within a range of literatures directed to or written by the Christian afflicted, exploring the ways that Evangelical ideas about suffering, medical assumptions about what constituted the incurable, and an ideology of self-help converged to encourage invalid authors to use the conventions of conduct and commonplace books and thus to produce a powerful model of Christian invalidism. To delineate the features that made this model distinct requires looking both at literature directed to the Christian “treatment” of invalids— for example, hymnals, prayer books, devotional manuals, and services for the sick—and at a substantial counterpart of spiritual literature written by invalids throughout the century and addressed to their fellow afflicted. These literatures combine to suggest not only the remarkable appeal of sickroom submission but also the surprising ways that invalids were empowered by Christian dogma, or empowered themselves through it, in order to take control of their physical and spiritual destinies. The Disappearance of the Physician: Religion as Remedy To understand the sick role as performed by the many anonymous authors of commonplace books of consolation, it is important to emphasize that their narratives make little if any reference to the nature of the diseases and disorders that confined them to their sickrooms in the first place. Outlines Selected from the Blotting Book of an Invalid is typical in its author’s oblique reference to the “adversity” he has encountered in life (141). Similarly, the author of The Solace of an Invalid compiled his collection of inspirational messages “at the request and for the use of a friend severely suffering in a long-protracted illness” (vii). And The Cup of Consolation was said only to have been compiled “by an invalid for the comfort of a sister invalid at a distance” (7). Discussion of disease etiology or the course of illness is virtually absent from most of these narratives, as is reference to the invalid’s prospects for physical recovery. The very absence of overt medical information might be seen as a commentary on institutionalized medicine. Anne Hunsaker Hawkins makes the important point that “all pathographies, even those that eventually discard traditional medical approaches, are situated

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within the social praxis of modern medicine” and hence “serve as commentaries on it” (18). Marginalizing or effacing discussion of the cause or course of disease was for some Christian invalids a way to refute medicine’s explanatory models and to subordinate its curative powers to those of religious discourse. Miriam Bailin makes a similar point when she writes that despite an increasingly specific terminology for bodily ailments available to laypersons and medical professionals alike, as well as a decided preference for empirical detail in fictional representation, the diseases from which the patients suffer remain for the most part unspecified. Although there is mention of bodily wasting and delirium, of fever and contagion, the conditions of illness remain reassuringly vague, merely the occasion for the benefits they elicit and the desires they legitimate. (Sickroom 7)

Unlike the invalid narratives examined thus far, the literature of Christian consolation makes little or no reference to interaction with medical men. Instead, God functions as the source of understanding and comfort. The woodcut frontispiece to the anonymous Letters from a Sick Room, published in 1845 by the Massachusetts Sabbath School Society, features an invalid turned away from window and mirror but nonetheless rendered contemplative; The Holy Bible, opened and resting on her lap, reveals the direction of her thought (fig. 15). “God hath smitten, and he alone can cure,” declares the author later in her narrative (49). The paradigm is replicated in Charlotte Yonge’s popular novel The Daisy Chain, for while Margaret May is attended to periodically by the family physician, she consoles herself and her family with her Christian belief. Of her helplessness she says, “God sent it, and put me in my place. He made me lie here, and will raise me up if it is good” (60) (fig. 16). In many commonplace books written by invalids, Christ is the sole source of healing. One hymn written for The Invalid’s Hymn Book significantly begins with the line, “Tell me of the great Physician,” and another with “O thou from whom all healing flows.” Similarly, the prayer “For Spiritual Peace” included in The Solace of an Invalid begins with the lines: Jesus, in whom the weary find Their late, but permanent repose; Physician of the sin-sick mind, Relieve my heart, assuage my woes. (231)

Somewhat less typical was Robert Brett’s Devotions for the Sick Room, which provided its invalid readers with a “Prayer for Physician and Attendants.”

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Figure 15. This woodcut illustration by F. E. Worcester appeared as the frontispiece to Letters from a Sick Room. 1845.

Like others of Brett’s selections, this prayer indirectly counsels invalids not simply to resign themselves to their afflictions but rather to accept man’s efforts at pain relief, efforts that he justified with prayers for divine support. Significantly, the “Prayer for Physician and Attendants” begins, “O Most blessed and eternal Saviour, who art the great Physician of souls; and the Sun of Righteousness arising with healing on Thy wings” (12). N. D. Jewson, Mary Fissell, and others have documented ways that the trend toward a scientific approach to medicine resulted in the “disappearance” of the patient from nineteenth-century medical cosmology.4 W. F. 4. See also Guenter B. Risse’s chapter “Medical Care” in Companion Encyclopedia of the History of Medicine, esp. 65–66.

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Figure 16. “Margaret and Ernescliffe,” an illustration from the Evangelical novelist Charlotte Yonge’s The Daisy Chain. 1856.

Bynum offers a slightly different perspective, arguing not for the patient’s “disappearance,” but rather for the increasing abstractness of the idea of the patient. “As a kind of abstract concept, ‘the patient’ seems to have acquired a more specific identity among doctors during the century,” he writes, “which is symptomatic, perhaps, of their increasing professional status and the new technologies distancing them from those they treated” (Science and

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the Practice of Medicine 211). Christian literature by invalids suggests that the disappearance of the physician from the patient’s narrative provides an equally compelling way to understand cultural transformations in progress. While the idea of being a “potential patient” is central to the sick role as delineated in Talcott Parsons’s classic study, Christian invalids conform more typically to the idea of becoming a “postpatient,” someone who may once have been under medical care but is now relieved of all the assumptions and expectations entailed by that relationship. Ellen Chadwick’s Weak, Yet Strong is unusual in its single reference to the “medical men” who had pronounced her case “incurable” (9). Neither Chadwick nor any other of the invalids who wrote texts geared to the consolation of fellow sufferers could be said to invoke a medical framework to understand their illnesses. It might be possible to intuit something of the invalid author’s medical condition from the intermittent references to “weakness” or to the “lingering” nature of an illness, but diagnosis, scientific understanding of disease, and the therapeutic value of medical treatment were clearly not part of the narrative agenda. This type of invalid text, more than any other, directs itself to a readership of fellow sufferers, but the presupposition is that neither author nor reader is on a “search for health” unless health is construed in a spiritual sense. Forgoing consideration of the onset of disease, the development of illness over time, or the response of the body to therapeutic measures, such narratives posit invalidism as an essentially ahistoric, transcendent experience. One explanation of the relative absence of medical information can surely be found in the words of the Reverend Richard Mant, who in his introduction to The Order for the Visitation of the Sick, from the Book of Common Prayer, a work widely available and used throughout the century, made the following observation to fellow clergymen: “It is expected that these Visits should be paid, when the Sick Person is capable of admitting them to his advantage; which, unfortunately for him, and much to the embarrassment of the Minister, is too frequently not the case; for every one who has the care of a large, or even a small parish, knows that the Visits of the Clergyman are often not required, till those of the Physician are become needless” (vi). It is difficult to ascertain whether Mant meant in his tone to convey cynicism or realism, particularly given how often medicine probably did in fact fail, if not in diagnosis, then surely in treatment and cure.5 5. Associating the failure of medicine to cure nervous disease with narrative indeterminacy, Athena Vrettos writes, “The causes of and cures for nervous illnesses remained open questions throughout the nineteenth century, yet this failure to categorize and control psychosomatic energies led to the proliferation of a cultural discourse in which they assumed spiritual and religious significance” (79).

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The lines separating religious from medical duties may well have been less clearly drawn than Mant’s passage suggests. In tracing the origins of the modern nurse, Perry Williams has noted that it was the Evangelical magazine the Christian Observer that published the 1821 article most often credited with first articulating the necessity of trained British nurses. Significantly, this particular article was signed by one identified only as an “Invalid” and based its plea for respectable and proficient sick attendants on the fact that “‘the chief object to a sick man’ is ‘his future existence’ in the next life.” The invalid author evidently then asks readers, “‘Who, in such a case, but would desire to have around him persons imbued with the same principles?’” (Williams 236). Lucy Bending posits a theological and medical “gulf ” opening up “between understandings of bodily pain in the 1840s and in the 1880s” (5), but it makes more sense to recognize the multiple ways that religious discourse and medical discourse came together to shape understanding of affliction. The nineteenth century is notable for generating certain medical categories of disease that point to the interfiliation of religion and medicine. Pathological terms such as “religious melancholia” and “religious mania”—the one signifying a patient who exhibits “great despondency as to his future salvation, or in which a morbid religious emotionalism tinges the mental aberration” and the other pointing to a patient with “assumptions of religious superiority” who believes “he must expatiate his sins on the cross” (Tuke, Dictionary 797 and 1092, respectively)—suggest that, if Evangelicalism helped to usher the physician out of the sickroom, the medical profession might just as easily intervene to usurp diagnostic control of the Christian sufferer (fig. 17). Richard Mant’s sense of the divide between the medical and religious spheres thus may well have been overdrawn, but his observation nevertheless foregrounds the unique position of “the sick person” at a crucial stage in illness when, hypothetically at least, a religious framework could supplant a medical one as the dominant mode of interpretation and treatment. The predominance of the religious model accounts at least in part for the extraordinary emphasis within The Order for the Visitation of the Sick on patience as the single trait most demanded of the Christian sick. “It is the duty of all to behave themselves patiently under the evils which are sent upon them” (4 –5), ministers were instructed to tell the afflicted. The passage continues: “God sends diseases upon us sometimes to try our patience, and . . . then it is our duty to bear his inflictions patiently” (5). Exhorting the sick to be patient at another point in his text, Mant explains that doing so is the best way to approximate Christ’s own suffering: “And there should be no greater comfort to Christian persons, than to be made like unto Christ, by

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Figure 17. “Religious Melancholia and Convalescence,” an illustration from the Medical Times and Gazette. 1858. Reproduced with permission of the Wellcome Library, London.

suffering patiently, troubles and sicknesses. For he himself went not up to joy, but first he suffered pain: He entered not into his glory, before he was crucified” (13). Just as the medical patient was rhetorically replaced by an idealized version of the sick person made patient by his obedience to God’s will, so too did a religious framework of understanding displace the idea of disease with that of sin, as illustrated by the following prayer, designed to be read during the fourth visit: “Renew in him, most loving Father, whatsoever hath been decayed by the fraud and malice of the devil, or by his own carnal will and frailness; preserve and continue this sick member in the unity of the church; consider his contrition, accept his tears, assuage his pains, as shall seem to thee most expedient for him” (64). Prayers appended to the Order convey a similar message, with spiritual impoverishment replacing physical disease as the root of disorder. In the “Petition for Improvement of Sickness,” for example, supplicants were instructed on the need for self-examination and advised, after repentance, to pray, “May the fruit of this and of every affliction be, to take away sin, and make my heart better” (124).

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The Order for the Visitation of the Sick thus suggests that some men and women adopted the invalid role at precisely the moment when they shed the more medically defined mantle of the patient. This shift has important consequences for an understanding of assumptions about the invalid’s identity in nineteenth-century Britain. Like other clergymen concerned with proper instruction during sick visits, Richard Mant attended in his work to the crucial differences between one at the beginning of sickness and one facing certain and nearly immediate death. Not surprisingly, he particularly welcomed opportunities to encounter the bedridden near the commencement of their illnesses when they were, in his estimation, less likely to say whatever it took to secure their salvation. Mant’s commentary throughout The Order for the Visitation of Sick makes it clear that, whether early or late in the course of illness, whether suffering from acute disease or chronic disorder, sick persons shared specific personality traits that made the clergyman’s task all the more challenging. As sick persons were “generally . . . not able to attend to long exhortations” and “too apt to forget what is said to them,” clergymen could not be too careful in planning how to steer them through the necessary channels of understanding toward resignation and repentance. The Order for the Visitation of the Sick nevertheless distinguishes in important, if subtle, ways between the broad category of sick persons and the smaller subset of long-suffering invalids. Mant draws often on the works of other “learned divines” to construct his program, and in a revealing footnote to a passage taken from the 1788 edition of Stonhouse’s Every Man’s Assistant and the Sick Man’s Friend, to which he evidently appended one phrase, he offers the following justification: The words, “If it be thy good pleasure,” are not in Dr. Stonhouse’s prayer. I have added them to qualify the foregoing petition, “restore him to health,” although indeed all our petitions are to be offered up in submission to the will of God. But as in some cases all hopes of recovery seem to be denied, and little or no ground seems left us to pray for it, I think the above petition is not suitable on all occasions. It is no uncommon thing for a Minister to visit a sick person labouring under a disorder of a very long continuance, of a recovery from which the least hope cannot be entertained from any human skill, and we have no warrant now to expect miracles to be wrought in favour of the sick. (3)

Mant’s reference to the particular contingencies imposed by those suffering from “disorder[s] of a very long continuance,” like his rhetorical maneuvering to ensure that these sufferers are not led to hope for—or literally

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allowed to pray for—restoration of health, helps to expose the particular ways that invalids were implicated in religious discourse on suffering. He comes back to the distinction at the close of his text when pondering the relationship likely to continue between sick persons and their ministers after the latter have discharged the formal duties delineated within the Order. Mant optimistically envisions the following scenario: “He will most probably feel himself disposed to continue, as the Sick Person mostly likely will be to receive his Visits, either till his recovery or decease; and that even if the illness should be of very long continuance” (102). One did not necessarily have to be the beneficiary of clerical visits such as those structured—one might even say prescribed—by Richard Mant to turn to religion to make sense of one’s illness, of course. Christian theology had for centuries rationalized pain by viewing it as subordinate to higher purpose. Throughout the long eighteenth century the afflicted “made sense of enduring suffering . . . by looking piously upwards to Providence,” a perspective that in turn valued the interpretation of disease as God’s will, that mandated the acceptance of this will, and that valorized a posture of resignation (R. Porter and D. Porter, In Sickness and in Health 235–40). Nevertheless, nineteenth-century editions of works such as Mant’s Order for the Visitation of the Sick not only made this inherited theology concrete and elaborated on it but also applied it more specifically—not to stages of illness, but rather to stages in the process whereby the sick person, through spiritual understanding, ostensibly came to terms with suffering. Taking the sick person and the attending clergyman through these stages, Mant’s text alternates in its representation of the sick person as a passive recipient of divine instruction and intervention and as an active agent in spiritual healing. First and foremost, the “sick person” addressed in the Order was to be made to understand that sickness was God-given, and to this end Mant provides his fellow ministers with the following sample of “spiritual advice” to offer at the beginning of the first visit: “Be assured that sicknesses and such sort of calamities are not sent upon men by God without cause; but for some good end” (4). Getting to that “good end” was easier said than done, not least because the sick person constructed within the Order was to be regarded with intense suspicion. Mant warns fellow clergymen that even “the sick Christian” who had already “professed his faith in God” must have “the truth of his repentance” investigated (31), and he repeatedly reminds these readers that they are in charge of ascertaining just how genuine the sick person’s supplications and testimonies are. The sick person is likewise instructed to “be not too tender of yourself,” not least because “the more severe you are in accusing and condemning yourself, the

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more favour you may expect of God” (43). A similar spirit of distrust underwrites the counsel designed for sick persons that “the promise of forgiveness should be no pretence for continuing in sin in hopes of pardon” (30). At several points in the Order Mant provides clergymen with a series of follow-up questions to direct to those visited and justifies his reason for advising them to be cautious of their responses by writing, “But lest Sick People, and such as are of slow understanding, should profess with their lips what they are not able to apply to their soul’s comfort; it will be highly charitable and useful, after repeating the Creed, to propose the use that ought to be made of it, in short questions” (22–23). In these and other ways, The Order for the Visitation of the Sick represents illness as a condition in which men and women become extraordinarily susceptible to dishonesty, the sick person either deluding others with false proclamations of faith or beguiling himself with fantasies of easily secured salvation. The sick person addressed in the Order is in this sense cousin both to the hypochondriac invalid, a victim of his own disordered imagination, and to the “blind” and “credulous” invalid addressed by those in the medical profession anxious about climatotherapy’s popularity. The extent of the suspicion that surrounds the sick person as represented within The Order for the Visitation of the Sick makes the limited control accorded the invalid at the end of the text even more surprising. Clergymen were advised to leave the Order with their sick if they deemed it expedient. More significant, a substantial series of prayers appended to the text were designed for the sick person’s own use. Although admittedly buried in the Order by the symbolic weight accorded to the clergy, such references nevertheless point to a dimension of sickroom culture in which the invalid assumed some management. Consider the following passage from The Autobiography of Elizabeth Squirrell of Shottisham: “My feelings were delectable, as supported by pillows, I would peruse my choice books, and write on paper my favorite pieces of hymns. I loved hymns much, especially those descriptive of our weakness, and God’s varied means of affording us consolation” (17). Squirrell’s description captures one of the ways that spiritual study became imbued with the ideals of self-help.6 Even bedridden invalids could 6. Although in Victorian studies “self-help” is almost synonymous with Samuel Smiles, the ideal of self-help permeated the culture more broadly than through the channels he dug. For an overview of Smiles’s vision, see A. H. Thornton’s Samuel Smiles and Nineteenth Century Self-Help in Education. Boyd Hilton includes a brief discussion of self-help in a religious context in The Age of Atonement: The Influence of Evangelicalism on Social and Economic Thought, 1795 –1865. Describing the beliefs of moderate Evangelicals, for example, he observes that “governments should interfere with men’s lives as little as possible, so that men can exercise ‘self-help’—the only means to salvation, both spiritually and economically—in a world beset with temptation, and meant for trial and judgment” (16). For more on the

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Figure 18. “A Boy Reading Scriptures to His Bedridden Mother.” Underneath the image appears the message, “In Sickness when the poor you see, / Will you their ministering angel be?” 1810s. Reproduced courtesy of the National Library of Medicine.

turn to spiritual study and make their condition profitable. Conceiving of sickness as a God-given trial led naturally to the idea of spiritual study as a means to salvation. Invalids had resources aplenty to choose from for reading and study; most in all likelihood simply consulted their own Bibles or family prayer books (or were read to from these same texts) (fig. 18). Just as the travel industry rushed to meet the emerging market of invalid tourists with guides prepared with their particular requirements in mind, so too could bedridden invalids consult tracts specially issued by the Society for the Promotion of Christian Knowledge or the Religious Tract Society, peruse manuals such as Devotions for the Sickroom, or opt for widely available specialized hymnals and prayer books (fig. 19). impact of self-help literature on our understanding of changing doctor-patient relationships, see Ginnie Smith’s “Prescribing the Rules of Health.” In his introduction to this same volume, Roy Porter offers an instructive caution about what kinds of conclusions can be drawn from such literature and points out that while “much of the advice dispensed, not least by doctors, centred on self-help . . . how the spread of do-it-yourself medicine would ultimately affect the dynamics of lay-professional relations is no easy matter to gauge” (16).

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Published in 1840 —nearly two decades before Hymns Ancient and Modern—and rapidly succeeding into four editions, The Invalid’s Hymn Book exemplifies the trend. At the time, hymns were controversial, associated as they were with the dissenting origins of Evangelicalism and the subject of great debates among nonconformist and orthodox church communities (E. Jay 124 –26). As author of an introductory preface to The Invalid’s Hymn Book, the Reverend Hugh White justified the enterprise by noting both the “peculiar character and circumstances” of the invalid and the “peculiar tenderness of sympathy, and discrimination of judgment” demanded of others (iii–iv). As he explained, “The bodily languor, which is the almost inevitable consequence of protracted illness, often indisposes the Invalid for enjoying a class of hymns, (to be found in all general collections,) which require greater energy and vivacity of spirit, than sickness, in most cases will allow” (iv). White obviously plays here on the association of Evangelicals with fervent hymn singing. As Robin Gilmour notes, hymns played a crucial role in providing communities of believers with “a sense of energy and joy” (73). Basing his selections on the assumption that invalids were incapable of making that expenditure of energy but were nonetheless not to be left out of the joy, White chose those he believed most “congenial to a wounded spirit,” hymns that either exemplified the “lamentations of resigned grief ” or suggested “the cheering motives for Christian consolation” (iv). Later in his preface, in an Figure 19. “Rock of Ages,” one of the “Hymns for the Time of Weakness” produced by The “R.T.S.” Invalid Library. 1896. Reproduced with permission of the British Library, London.

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“Address to the Invalid,” he provides additional justification of his material, observing that during periods of “great bodily weakness . . . the variety of a large collection, becomes wearisome, and the small print, and weight of the volume, inconvenient” (xxxiv). Given the extent to which The Order for the Visitation of the Sick scripted a subordinate posture for the sick person, it is significant that White collaborated on his hymnal with an invalid. His preface indicates that “the design of the present little work . . . was originally undertaken by one, preeminently qualified for the task, from her experience both of the wearisome days and nights appointed for the Invalid—and of the rich and precious consolations, with which the Gospel of our Lord Jesus Christ abounds— one, who combined the highest intellectual attainments with the deepest Christian humility” (v). Although she evidently died, this invalid was, White assures his readers, “soothed and solaced many a weary hour during her last illness” (ix) by her carefully arranged hymns. White’s preface reveals several key assumptions driving his view of the potential market for his hymnal. At one point he recommends it “to those . . . who, under the pressure of bodily pain and weakness, desire to experience the refreshing influence of Christian comfort, clothed in the attractive garb of sacred song, or to those who wish to present to beloved relatives or friends, confined to the bed of suffering, or the chamber of sickness, such a token of sympathy, and such a minister of consolation”(x). White envisioned The Invalid’s Hymn Book as a surrogate source of domestic comfort, “a delightful substitute in the sickroom for that participation in singing the praises of God in family worship, from which sickness often excludes him” (xxi). Although he trumpets the virtues of the invalid originally responsible for selecting and arranging some of the hymns, White brought to his hymnal assumptions similar to those underwriting The Order for the Visitation of the Sick. He explains at one point, for example, that his most recent edition was designed to accommodate an additional “class” of sufferer, what he describes as “the reflecting, awakened, and inquiring Invalid, to whom the language of the confirmed believer cannot be intelligible, and consequently cannot be profitable” (xii). He imagines that for this group his hymnal will serve “as a means of making their sickness instrumental in promoting their everlasting welfare, by leading them to self-examination, and thus to a discovery of their own sinfulness, and of their consequent need of an almighty and all-sufficient Saviour” (xii). And he urges all invalids to embrace the “invaluable opportunity” sickness has given them “by the exhibition of cheerful submission” (xxi).

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The Invalid’s Hymn Book, far more than The Order for the Visitation of the Sick, was designed for personal use. After an “Address for the Invalid,” White divides the hymns into four parts: “Hymns suited to the awakened Inquirer,” “Hymns suited to the humble penitent, and rejoicing believer,” “Hymns suited to Seasons of Severe Suffering, mental or bodily,” and “Hymns suited to the dying Christian.” Not unlike popular religious texts today, the hymnal provides readers with a thumbnail, thematic guide to the contents that functions as a taxonomy of invalidism in nineteenth-century society. Among the “particular occasions” noted are the following: “When prevented by illness from going to Church”; “When unable to sleep from restlessness or pain”; “For a person suffering from nervous dread of illness”; “Under depression from deafness”; “On leaving home for a milder climate”; “When the spirit has fled.” Invalids consulting White’s volume had nearly two hundred hymns to choose from, nearly a third of them “prepared exclusively” for the text. Most of those not original to the volume seem chosen for the relevance of their lyrics—“Rock of Ages,” with its appeal to “be of sin the double cure,” for example, or “We sing the praise of him who died,” which refers to “the balm of life, the cure of woe.” Wide-ranging in the emotions presented, the hymns purportedly composed for the volume depict sickness as both “a school severe” and “a hallowed season.” The following hymn typifies the kind of material collected: When paroxysms of pain acute, Seized on my throbbing head; And fiery darts appeared to shoot Along each nerve’s fine thread: What heavenly anodyne had power To calm me in that suffering hour? I thought on Him, whose sacred brows For me with thorns were torn; Then buffeted with impious blows, In meekest silence borne; One look at thee, my Saviour mild! Calmed and reproved thy suffering child. I bear the needful chastisement My sin-sick soul requires;

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But thou, my God, were well content To pass through fiercer fires: That thy most precious blood might win Eternal pardon for my sin. (174 –75)

The hymn is particularly interesting in its use of a generalized medical language —first to render the speaker’s suffering (“paroxysms of pain”), then to localize it (along “each nerve’s fine thread”), and finally to relieve it (via “heavenly anodyne,” a word that significantly conveys both the alleviation of pain and the provision of something soothing in its place). The second stanza depicts the invalid as finding pain relief through religious contemplation, which brings her, we learn in the last stanza, not simply to repentance but also to an understanding of herself as “sin-sick.” Many of the original hymns similarly chart a movement from corporeal disintegration into spiritual understanding and relief: When pining sickness wastes the frame, Acute disease, or tiring pain— When life fast spends her feeble flame And all the help of man proves vain; Joyless and dark all things appear; Languid the spirits, weak the flesh; Medicines nor ease, nor cordials cheer; Nor food nor balmy sleep refresh: Then, then to have recourse to God To pour a prayer in time of need, And feel the balm of Jesus’ blood, This is to find relief indeed. (192)

This hymn, which many invalids selected for their commonplace books, is typical both in its emphasis on the ineffectuality of all things human in bringing healing or relief and in its representation of disease as preparing the body for spiritual understanding. In an anonymous book titled Think! published in 1838, for example, this hymn appears alongside a series of prayers, among them “For a True Spirit,” “For a Person When in Pain,” “For

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Repentance,” and “To Be Used after Sickness.” The healing that accompanies the spiritual understanding trumpeted in the hymn comes only after the invalid has “recourse to God” and prays, gestures that stress the invalid’s own agency in response to suffering, the figure’s ultimate responsibility for securing relief. Texts such as The Invalid’s Hymn Book clearly sought to perform a therapeutic function, both by registering the spiritual and emotional woes likely to be experienced by those who suffered physically and by inspiring the sufferer to seek relief through God. Many of the tracts issued by the Society for the Promotion of Christian Knowledge, which like the hymnal were designed for personal use, sought to achieve the same effect. Published in 1852, “The Only Cure” encouraged readers to liken their own suffering to that depicted in the story of the suffering woman in the book of Mark and to take comfort that, just as “this poor woman has before her a remedy within reach,” so too might they. Similarly, the tract titled “The Spirit of Infirmity” based its message on the story in Luke 13: “How does the conduct of this poor afflicted woman reprove those, who for every trifling excuse absent themselves from the house of God!” its author observed. A section titled “Patience in Affliction,” included in the 1853 tract “The Invalid’s Friend,” drew on the following passage from the book of Romans: “We glory in tribulations also; knowing that tribulation worketh patience; and patience, experience; and experience, hope.” Like the tracts from the Society for the Promotion of Christian Knowledge, manuals such as Robert Brett’s Devotions for the Sick Room were intended for use by invalids. Brett dedicated his book to one who “was cheered by these devotions” and who “was enabled with cheerful patience to follow Him, in hunger and thirst, in painfulness and weariness, through a long protracted period, until she fell asleep in Him,” and in an advertisement for the third edition of his volume he made reference to “the numerous testimonies he ha[d] received of benefit derived from this book, by persons suffering under almost every form of bodily affliction, or mental anguish.” As did Hugh White, he selected “short and fervent petitions” for his manual, indicating that they were “most suitable for invalids, who are seldom able to go through a long continuous prayer” (v). Structuring his manual around morning and evening services and providing “Special Scriptures and Prayers for the Time of Sickness,” “Prayers to be used as the hour of Death approaches,” occasional prayers, and “Sentences and Prayers for the Feasts and Fasts of the Church,” he provided his invalid readers with material to be consumed year round, from dawn till dusk.

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Assumptions about the invalid’s mentality and needs surface most vividly in the section titled “Special Scriptures and Prayers for the Time of Sickness,” whose contents reveal familiar themes of Christian suffering— for example, the idea that afflictions are sent by God and that suffering should be endured with patience and resignation. Perhaps more important, these devotions indirectly taught sufferers which dimensions of their condition most required divine intervention. In “A Prayer for a Blessing on the Means Used,” invalids invested their physicians with spiritual import, praying, “Almighty God, forasmuch as Thou hast ordained the physician for the benefit of those who languish under any bodily distemper, I have resolved to try his skill” (50 –51). In “On taking Physic” invalids were similarly directed to invite spiritual intervention in the medical process: “O Lord, without whom all my endeavours are but vain, give Thy blessing to the means now used for my recovery, and (if it be Thy blessed will,) make them so effectual for that end, that I may live, and be an instrument of Thy glory, and better prepared for the coming of the Lord” (51). Essentially arguing against complete resignation to suffering and disease, such petitions—encouraging the afflicted to pray for divine participation in medical treatment—quietly make problematic the issue of the Christian invalid’s agency in healing. In “A Prayer That the Affliction May Be Profitable,” the sufferer beseeches the Lord to help “find out the accursed thing that has brought this affliction upon me” and to “make me so sensible of my manifold provocations . . . that this correction may appear the effect of Thy love and pity” (52). In a variety of ways, these tracts and manuals legitimated the invalid’s suffering by ensuring its ultimate profitability. While it is sometimes argued that for the Victorians illness “authorized the relaxation of rigidly conceived behavioral codes” (Bailin, Sickroom 12), Christian tracts and manuals such as The Order for the Visitation of the Sick and The Invalid’s Hymn Book make it plain just how scripted was the role that formal and institutionalized religion asked the sick Christian to perform. Deathbed behavior was arguably the most overdetermined part of the performance, but it was not the only opportunity the sick had to demonstrate Christian belief and values.7

7. Elizabeth Jay includes a substantial discussion of the “death-bed cult” within her observations of Evangelical forms of practical piety (156–68). Miriam Bailin calls the deathbed the “mise-en-scène of high drama and ultimate meanings” but argues, correctly I believe, that “the scene of illness derives as much of its significance from the prospect of eventual recovery” (Sickroom 16). See also Margarete Holubetz’s “Death-Bed Scenes in Victorian Fiction.” Holubetz contends that while the Evangelical influence was formidable, “the Stoical attitude of meeting death with fortitude and courage survived” as well (15). She writes that “the ritual celebration of death—so radically different from our customs—was the ideal to which people on their death-beds aspired” (16). Finally, Trev Lynn Broughton

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To be “long-suffering” was, after all, one of the defining characteristics of the Christian spirit. As Louisa Hopkins recorded in her commonplace book, The Silent Comforter, “To be a Christian, and a suffering Christian, is a double honor” (35). And no place was more conducive to that spirit than the Victorian sickroom. Chambers of Sickness, Beds of Pain: Commonplace Book Conventions The commonplace books written or compiled by invalids during the period draw from and replicate many of the attitudes about suffering found in hymnals and prayer books as well as in devotional literature. They make it clear, in other words, that many invalids took their cues for how to perform the sick role from the discourse emanating from this institutional body of literature. One of the most distinguishing features of commonplace books by invalids is that many were marketed as being written either “from the sickroom” or “for the sickroom” and thus share with invalid-written travel books a relatively precise sense of purpose. Often referred to in tracts and hymns as “the chamber of sickness,” the sickroom evoked images of enclosure, isolation, and imprisonment. In an illustration created for Dickens’s novel Hard Times, Frederick Walker picks up on these associations. In this image, the sufferer’s face and torso are hidden behind the bed curtains; one hand holds a cup and the other reaches for some medicine (fig. 20). Invalids themselves found numerous ways to render their experiences as confining. The author of Letters from a Sick Room, for example, reached out through her work to a community of sufferers she described as “tenants for life of one small apartment” (vi). Louisa Payson Hopkins prefaced The Silent Comforter: A Companion for the Sick Room with the words, “The chamber of sickness!— what a gloom is cast over the mind by the words!” (3), but many of her fellow invalids used its connotations as a sanctuary to stage the sickroom as offering unique privileges to those confined within it. They invested their books of consolation with the value to “illumine the lonely sick room and make it an abode of cheerfulness and joy” (Letters from a Sick Room ix). Perhaps most important, the sickroom was designed with the invalid’s particular needs and “requirements” in mind. The tips and advice offered in Isabella Beeton’s massive and influential Book of Household Management illustrate well the kind of environment thought to be necessary for invalids. looks at the deathbed scene through the lens of gender, likening it to a “makeshift pulpit” and describing it as the “cultural apotheosis” of the “premium on feminine suffering” (39).

Figure 20. “Stephen and Rachel in the Sick Room,” an illustration by Frederick Walker created for Charles Dickens’s novel Hard Times. 1868.

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With characteristic detail, Beeton provided meticulous instruction to those responsible for the care of invalids confined to sickrooms, advising them to ensure minimal noise and activity, dim lighting, and the quick removal of potentially bothersome smells. The fairly extensive section “Invalid Cookery” cautions those tending to invalids to avoid large quantities of food and to “always have something in readiness,” noting that “small delicate pieces” of food will most likely be agreeable to the sufferer. The recipes—for everything from egg wine and eel broth to gruel, “invalid’s jelly,” rice-milk, and toast-and-water—emphasize the mild and easily digestible. Miriam Bailin has called attention to the Victorian sickroom’s emphasis on “the simple gratifications of infancy” (Sickroom 13), an assessment easily illustrated by the figure of the invalid that emerges from Beeton’s household manual. The invalid constructed within the pages she devotes to the sickroom is someone extraordinarily vulnerable and sensitive to all sensations. Although written much later in the century, Julia Duckworth Stephen’s Notes from Sick Rooms (privately printed in London in 1883) makes many of the same assumptions regarding the invalid’s susceptibility to sensation: “There are . . . patients who, without meaning to be exacting, are so delicately organised, or whose senses have become so acute through suffering, that they can detect a draught or a smell where even careful and discerning nurses can find neither” (25). No matter escaped Stephen’s attention, and her book consequently covers everything from “the torment of crumbs” in an invalid’s bed, the sensitivity of an invalid’s skin after washing, what kind of comb works best for an invalid’s hair, what to do about the problem of candle smoke in a sickroom, and how to place plants and flowers “so as to show their best shape and colour to the invalid’s eye” (32–33). Stephen places nearly as much emphasis on the patient’s mind as on physical needs and in doing so reveals that caretakers were as likely as invalids themselves to construe the sickroom as a sanctuary. Nurses are instructed to carry about them a “quiet brightness” and cheerfulness: “No one should venture to attend the sick who wears a gloomy face” (4). Just as certain segments of the medical profession sought to highlight the “blind credulity” of invalids embarking on journeys abroad to find health, so too the nurse or caretaker addressed in Stephen’s text is taught to be skeptical of the invalid’s capacity to respond rationally in certain circumstances. “Watchers” in the sickroom are granted permission to lie, for “if trouble should come . . . it is important that the invalid should be kept in ignorance” (5). “Invalids’ fancies seem, and often are, absurd,” she writes at another point (24), urging her readers not to argue, for “one of the chief duties of a nurse is to make her patient thoroughly comfortable in mind and body” (25).

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Works such as Beeton’s Book of Household Management and Stephen’s Notes from Sick Rooms expose the multivalent potential of the sickroom as the setting for a certain kind of invalid production—the commonplace book, with its emphasis on the invalid’s spirit. When invalids wrote or compiled these books “for the sickroom” or “from the sickroom,” they did so with an evident understanding that the space itself influenced the experience of those within it. Lynda Nead has written provocatively of the capacity of social space to construct subjectivity, its function “not as a passive backdrop to the formation of identity, but [as] part of an active ordering and organizing of . . . social and cultural relations” (167). The sickroom signified an environment uniquely suited to an individual at once in submission and in command. Insofar as the figure of the invalid both embodied and signified stasis and inertia, the sickroom functioned as its spatial equivalent, an association captured in Miriam Bailin’s analysis of the sickroom’s function in realist narratives: “Preeminently a strategy for survival, the sickroom combines a reassuring sense of closure with the sustained possibility of sequence continually deferred” (Sickroom 17). Bailin also observes that the sickroom functioned simultaneously as a “consoling community” and as a “forcing ground of the self ” (Sickroom 5). These seemingly contradictory functions in fact underwrite the stance taken by invalid authors eager to subsume their individual identities under the rubric of “Christian sufferer.” A “consoling community” of sufferers was in many ways a staple ideal extolled in the dedications and prefaces to the commonplace books that invalids compiled for one another. A frequent contributor to the Society for Promoting Christian Knowledge, the Reverend James Endell Tyler found himself confined to a sickroom in 1851, and he prefaced his address to parishioners, “A Voice from the Sick Room,” with these remarks: “I cherished a heartfelt desire to address you, though not with my voice, yet with my own hand; that while I was absent from you in the body, ‘shut up’ and ‘not able to go to the house of the Lord,’ a few words of kind remembrance might find their way from the chamber of sickness to your own homes and not be felt by you as an unwelcome or untimely intrusion” (6–7). Just as the author of The Cup of Consolation selected her contents “for the comfort of a sister invalid at a distance” (7), the anonymous author of The Invalid’s Own Book proffered her “topics of consolation” to “some fellowsufferer, to whom the compiler would not otherwise have access” (preface). Fanny Henslowe, compiler of Literary Gleanings by an Invalid, dedicated her book to her “Sisters in Affliction and Suffering, Wherever Ye Be,” and C. Howard Young, author of Sunny Life of an Invalid, dedicated his “to a Blind

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Friend, by an Invalid Confined for Life.” “To all the sufferers from disease, in whatever form, whom this little book shall reach, may its words prove a solace and a support!” Louisa Hopkins proclaimed at the end of her preface to The Silent Comforter (4). Like so many others who compiled books of consolation, these authors saw themselves as reaching across the confines of the sickroom, using their texts to connect fellow sufferers. Little record remains of how these books were received and responded to, so it is difficult to reconstruct how well the invalid authors’ professed goals were met. It is hard not to see exaggerated pathos in their depictions of the physical and psychological isolation of their sphere; among the lines from the hymn “Chamber of sickness!” quoted in The Invalid’s Own Book are the following: Chamber of sickness! suffering and alone, My friends withdrawn, The blessed beams of heavenly truth have shone On me, forlorn. (98)

The isolation described by this invalid author, as by so many others, makes the desire to connect with other sufferers all the more powerful. In their appeal to a broader community of suffering readers, noted in dedications and prefaces, these narratives seem to construct a permeable sickroom; invalid authors’ “reach” is clearly believed to extend beyond the confines of their individual space and to affect the similarly sequestered. In this particular respect, nineteenth-century invalidism should be understood in distinction to the sick role as delineated by Parsons, who argues that the “sick are tied up, not with other deviants who form a ‘sub-culture’ of the sick, but each with a group of non-sick, his personal circle and, above all, physicians” (477). In other respects, however, the role of the Christian invalid in nineteenth-century Britain depended on the assumption of nearly complete isolation. Isolation was not simply conducive to introspection, in some sense it was the most fundamental condition of the selfexamination demanded of the Christian in his “chamber of sickness,” that “forcing ground” of self (Bailin, Sickroom). Robert Brett’s Devotions for the Sick Room included a substantial section titled “A Penitential Office,” compiled from the Book of Common Prayer and other devotional writings, oriented entirely toward self-examination. It begins with an “exhortation to self-examination” and continues with subsections devoted to different stages—for example, “A Prayer before Self-Examination,” “Heads of Self-

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Examination,” “Examination of Religious Actions,” and “Exhortation to Repentance.” Invalids who compiled their own devotional or commonplace books made much of the sufferer’s unique opportunities for selfexamination. As Louisa Hopkins noted in a section titled “It is Good for a Man That He Bear the Yoke,” “The afflicted one is blessed with retirement, free from the bustle and din of the world; has an opportunity for reflection, self-examination, and self-dedication to God, which the season calls for” (73). The poems and prose passages chosen by Hopkins and other invalid authors were presumably selected to promote or enhance that selfexamination, which, it is worth emphasizing again, presupposed some agency on the part of the sufferer. The figure of the invalid that emerges from the text is both producer and consumer. The producer has created the text through compilation after absorbing insights from the selections and undergoing self-examination; the consumer is presented with a menu designed to encourage replication of that process. Examining the substance of the inspirational poems and prose more closely reveals a crucial feature of this textual dynamic, however, for the encouragement toward selfexamination seems to be undercut by a parallel emphasis on the erasure of self. These seemingly incongruent elements are abundantly in evidence in Louisa Hopkins’s The Silent Comforter: A Companion for the Sick Room. Several themes emerge as common to Hopkins’s selections—for example, the idea of affliction as a source of learning, the vanity of worldly comforts, the blessings of pain, and the temporary and transient status of the body. Many of her selections address specifically the same issues found to be central to more institutional documents such as The Order for the Visitation of the Sick or The Invalid’s Hymn Book. For example, Hopkins provides readers with a poem titled “Patience” as well as a prose passage, “Patience in Sickness,” elaborating on the same theme (86–87). The encouragement toward selfexamination comes through in a wide range of ways. A selection titled “Sickness a Teacher,” for example, begins: “How fast we learn in a day of sorrow! It is as if affliction awoke our powers, and lent them new quickness of perception” (11). “When we are under pain of body, it is proper to reflect how vain is everything in this world,” she instructs at another point, reminding her readers that the “one great recommendation of affliction” is that “it is a time of wise and more sober thoughts, a time of the returning of the mind inwards and upwards.” The irony of this enthusiasm for thought and reflection is, of course, that it seems to work against the parallel command to annihilate self. Consider

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as just one example the following passage included in a section titled “In All Our Afflictions He Is Afflicted.” Hopkins writes, It is the will of God that we should be “freed from sin, and made perfect through sufferings.” Were there no cross there should be no crown. Our nature must be purged. We never know ourselves till we are tried; consequently, we cannot fight against our besetting sins till we are made acquainted with them. Self must be crucified; but instead of enduring the trial with reluctance, and with many efforts to escape, the Christian should go through it willingly, and esteem it an honor to become a partaker of his Master’s sufferings. (71)

The passage is a remarkable illustration of the sweep of the command to excise “self ” from—and through—suffering. Not only does the sentence “our nature must be purged” suggest an almost Eucharistic purification, but the stunning declaration that “self must be crucified” powerfully likens the Christian invalid to Christ on the cross. Not all Christian invalids pushed the analogy to the extremes seen in The Silent Comforter, but many confronted the dilemmas posed by the ideal of self-examination as means of self-extinction. In Up the Hill Difficult, M. Giles identifies “Self-Concentration” as “one more steep ascent” for the invalid, for “at first sight one would think that the endeavour to get rid of the trouble would only add to it, as it would apparently cause us to concentrate our minds more than ever upon ourselves” (113). Acknowledging that “who that is in great pain can think of anything else,” he counsels invalids “shut in with self ” to begin their self-examination with a meditation on Christ’s suffering and contemplation of this question: “Was there a thought of self, of His Pain, His comfort, think you, in those hours on the Cross? . . . What are your sufferings in comparison with His?” (116). Many invalids no doubt found more comfort in the kind of explanation offered in devotional manuals and tracts such as “The Spirit of Infirmity,” which counsels its invalid readers that “a habit of self-contemplation differs entirely from the exercise of self-examination which is necessary to our welfare, and is far more likely to lead to a sullen and despondent state of mind, than to a lively and active faith, and to exertion in God’s service” (10). This author represents the invalid’s self-scrutiny as legitimate because it is an “active” and “lively” form of “exertion” or, in other words, a form of work. Not only does this rhetoric illustrate one of the ways that Evangelical discourse ascribed agency to the Christian invalid’s characteristic posture of submission and resignation, but it also complicates the notion that the invalid who adopted

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a passive posture necessarily adopted a more feminized one or one with class-bound associations of idleness. Other features of these books of consolation reveal their commitment to a kind of self-scrutiny that presupposes a fundamental decentering of self. Most, for example, limit personal narrative —discussion of the author’s own experiences with suffering—to opening dedications or brief prefaces. After these prefatory moments, the author’s (or compiler’s) personal voice is virtually erased from the text, and the authorial role is diminished to that of a producer and facilitator. Keynotes of the Christian invalid’s theology emerge through the repetition of certain themes in the contents of consolation literature (e.g., piety, obedience, submission, and resignation), but the repetition itself further diminishes the uniqueness and individuality of any given invalid’s experiences. While certain themes repeat themselves, these commonplace books of consolation themselves were structured in different ways, each revealing certain dimensions of its invalid author’s attitudes and predilections. While some drew entirely from religious materials, others drew from literary sources of consolation. J. R. Macduff expresses anxiety about assimilating the biblical to the literary throughout his lengthy introduction to The Cup of Consolation.8 Although claiming to argue for nature’s restorative powers and their potential benefit to those sequestered within the sickroom, Macduff presents a defensive explanation of the text’s juxtaposition of the literary with the biblical, arguing that nature’s healing potential was almost equal to that of the “Living Water.” “But it is only the invalid, shut out from the enjoyment of external Nature, who knows the gladdening and invigorating thoughts her varied volume can impart,” he writes, before explaining that while those endowed with the gift of health and strength can revel at sweet will amid these teeming records of the outer creation, alas! it is often by hearsay alone that the bedridden sufferer can enjoy the music of stream, and song of bird, and gush of waterfall. It is often alone, through brief descriptive sentences, that mental glimpses can be caught of the starred patches of moss and lichen, or of the chequered light in the sylvan glade —not unfrequently, indeed, the darkened chamber denying sight even of the golden flush of sunrise, or the purple piles of western cloud. (9) 8. Macduff was also the editor of The Gates of Praise, a collection of hymns, poems, and verse fragments that in turn provided many invalids with inspirational materials for their own commonplace books.

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As if that weren’t convincing enough, Macduff goes on in his introduction to describe literary artists as “gifted interpreters of nature” whose words function as “chalices of consolation” and then to explain that “some such chalices fetched from God’s own fountains in His own material world have in this volume been judiciously and happily combined with those filled from the pools of inspired and sanctified thought” (10). It is difficult to imagine why Macduff felt so compelled to defend the selection of material in The Cup of Consolation. After the introduction, the book proceeds in the fashion of much contemporary self-help literature, with daily entries organized around biblical passages that are then followed with excerpts of an essay or a poem. The entry for 5 January, for example, includes the following lines from the book of Psalms and the book of Timothy: “To behold the beauty of the Lord,” “Who giveth us richly all things to enjoy,” and “The earth is full of the goodness of the Lord” (19). The prose excerpt that follows these biblical passages reads in part, “Beauty is God’s handwriting; a wayside sacrament. Welcome it in every fair face, every fair sky, every fair flower, and thank for it Him, the fountain of all loveliness, and drink it in simply and earnestly, with all your eyes: it is a charmed draught, a cup of blessing” (19). Throughout The Cup of Consolation, biblical selections are juxtaposed to passages from other inspirational books, among them Restful Rhythms, Watchword, Gates of Praise, and Watchwords for the Warfare of Life. Among the many authors quoted are Elizabeth Barrett Browning, Thomas Carlyle, Canon Charles Kingsley, John Keble, the Reverend C. H. Spurgeon, and Violet Fane. The invalid reader of The Cup of Consolation was encouraged, if implicitly, to synthesize the materials presented. Indeed, the format of this type of book posits a practice of reading with interesting implications for an understanding of the ways religious discourse usurped paradigms more traditionally ascribed to the medical. Medical historians have paid much attention to the ways patients and their practitioners negotiated the terms for understanding and comfort, but in these commonplace books negotiation is more wholly under the control of the invalid reader, the one who presumably ponders and synthesizes the meaning of particular passages in order to achieve the therapeutic benefits of solace, consolation, and cheer. In The Invalid’s Own Book, for example, readers are told in the preface that the compiler, identifying herself only as a “fellow sufferer,” found it a “pleasing and profitable employment” to select and arrange her favorite passages, which she has altered or abridged to be “adapted to her own circumstances and feelings.” Apologizing for not having in every case supplied her

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sources, she offers some fifty-six entries, each with a biblical selection and supplementary prose or poetry excerpts. Some of these excerpts were gleaned from the Wesleyan Methodist Magazine and others from sources such as Sympathy of the Atonement, The Christian Treasury, Gems of Sacred Poetry, and Nisbet’s Series of Tracts. The Reverend Hugh White was an influential source, his hymnal providing her with several poems, including “Chamber of sickness!” as well as with an array of prose passages. Invoking the popular trope of the invalid as a “sick prisoner,” the compiler created one entry built around Psalms 69:33, which reads: “For the Lord heareth the poor, and despiseth not His prisoners.” This passage is then supplemented with an unattributed prose passage that reads in part: “Many of the Lord’s people are prisoners, placed in the solitude and confinement of their sick chamber. Yet does not their heavenly Father place them there, that, apart from the din of the busy world, He may whisper His love into their hearts in sweetest, softest accents?” (72). This author goes on to argue for the value in being deprived of nature’s pleasures, shut out from the “beautiful objects” of the world, for when “the eye cannot be satisfied with seeing,” she writes, “what vast fields of contemplation lie before us!” (73). Thus, unlike the invalids addressed in J. R. Macduff ’s introduction to The Cup of Consolation, these invalid readers are encouraged to separate self from the temporal dimensions of this world and to limit their thoughts to their “bright inheritance above” (73). The varying formats of commonplace books by invalids reveal important differences in the assumptions made about invalid readers’ abilities and needs. The author of The Solace of an Invalid assumes that readers’ bodily weaknesses would inevitably impair their mental abilities: “The memory partakes of the debility of the frame; she anxiously endeavours to find an anchorage, but is too feeble to effect it, and is the sport of every passing fancy, unfixed and fluctuating” (ix). The book’s wide-ranging selections hence ensure that the invalid’s mind will stay “habitually acquaint[ed] with God” (x), and to that end he includes material such as a “Hymn in Time of Sorrow,” sermonlike passages with titles such as “The Practical Uses of Affliction,” prayers such as “For Sanctification in Sickness,” and poems such as “Lines Written under the Pressure of Severe Disease.” Like The Invalid’s Own Book, What Is It To-day? Sunday Half-Hours with an Invalid presents its readers with a series of similarly structured chapters, each beginning with a biblical passage that is followed by a short commentary with sermonlike overtones. After reviewing the story of Jonah, for example, the author asks his readers to ponder its applicability: “But do we, dear friend, thus regard our own lives and God’s orderings for us?” (25). In Up the Hill Difficult, M. Giles presents

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the propensity to question as the single most deleterious preoccupation of the invalid. Referring his readers to the story of Job and to stories in the books of John and Luke, he writes in characteristically overblown rhetoric: “This great rock, which blocks our way when we are starting to climb, the great why?—why am I thus? why does God allow shattered and suffering lives?—can be blasted to a great extent by the study of three stories given us in the Bible” (11). This particular juncture in Up the Hill Difficult exposes especially well the conflicting messages that invalids doled out to one another in their consolation books. While the very format and ideology of the commonplace book authorized readers’ intellectual engagement with ideas, Christian invalids were also counseled toward an acceptance of divine will that militated against intellectual engagement, a resignation that instead demanded unquestioning acceptance. As Hannah More taught —in a passage selected by Fanny Henslowe for Literary Gleanings by an Invalid—“Submission is only yielding to what we cannot help. Acquiescence is a more sublime kind of resignation. It is a conviction that the Divine will is holy, just, and good” (109). Perhaps more than any other type of invalidism, the Christian brand—by virtue of its emphasis on resignation— seemed in some ways to deprive the sufferer of agency, the capacity to invoke will, exert power, take action. Given these associations, it is no surprise to find that this particular sick role seemed especially suitable for—even natural to —women. Revolving around key concepts of submission and resignation, the discourse scripted for the Christian invalid demanded that narratives foreground the virtue of acquiescence that Hannah More preached. Ellen Chadwick’s narratives strike these very chords so frequently as to seem formulaic; nevertheless, her posture is made problematic in ways that suggest how very complex was the Victorian understanding of the resignation thought to be embodied by the Christian invalid. Many feminists and cultural critics have argued for the importance of reading bodies as symbolic surfaces on which cultural codes are inscribed, claiming that it is from such surfaces that “resistance” originates and is registered. But applying this model to the Christian invalid of nineteenthcentury narratives, a figure identified not with resistance but with resignation, poses more difficult questions. The literature of Christian consolation endowed the invalid’s posture of resignation with unusual honor, but even so the demand to be unquestioning was formidable, and perhaps even untenable. The poem titled “Sonnet. Resignation. 1840,” included in Occasional Poems. By an Invalid attempts to evoke the internal tensions the sufferer experienced:

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I murmur not, but with patient heart, And calm, to present misery resign; Blessings beyond all price had long been mine; I knew them frail, and felt that I must part With all: still trembling while I priz’d them most, And conscious that on Earth the purest Light Still casts the deepest Shadow: thus aright I read my lot—but O! how vain the boast Of mind or heart prepar’d, that lot to meet In all its unimagin’d bitterness! Its soul-felt desolation! Not the less I check each sigh, and with obedient feet Pursue my path! To cheer its darkest hour One Light is beaming still—still blooms one peerless Flower.

The very proliferation of commonplace books for invalids, filled with passages to inspire contemplation, might be said to represent the relentlessness of a population’s engagement with the problem of suffering. One way to appreciate how far that engagement in fact constituted a kind of questioning, if not doubt, is to examine the rhetoric of schooling that invalids repeatedly deployed in consolation texts. Variously conferring on themselves the roles of teacher and of student, many Christian invalids found the rhetoric ideally suited to their sick role. In compiling commonplace books for themselves and their fellow sufferers, some invalids adapted their sick role to that of the teacher; that is, they chose materials designed to guide afflicted ones through suffering to consolation, solace, and resignation, each central to a religious model of healing. The author of What Is It To-day? Sunday Half-Hours with an Invalid sometimes prefaced commentary on the biblical selections with the phrase, “Another striking lesson, dearest ——,” rhetoric clearly positioning her as instructor and her reader as student. As frequently, invalids foregrounded their role as spiritual students, as when M. Giles wrote in Up the Hill Difficult that “many good results come from invalid life. We gain time (a great thing in these hurrying days) to get nearer to God; and we may learn, and have opportunity to put into practice, many difficult lessons, and so to grow strong in character” (14). Similarly, the author of The Solace of an Invalid observed that “thus taught in the school of adversity how to estimate the objects of the world, we return (if death close not our career) to the business of life fortified against many tempta-

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tions which, had we been undisciplined by the ‘chastening hand,’ might have plunged us into guilt” (76). These two postures come together vividly in the writing of Ellen Chadwick. Nowhere is the rhetoric more evident than in Chadwick’s Weak, Yet Strong and Echoes from a Sick Room, begun in 1886 and completed in 1902. Educated in her much vaunted “school of long affliction,” Chadwick—who had come to be known as the “Famous Manchester Invalid”—usurped the power of the pulpit and, from her bed, preached the “lessons learned” within the sickroom. Transforming herself from “patient sufferer” into bedroom prophet, Chadwick took the association of illness with spiritual privilege to an extreme. Her work exposes not just inconsistencies underwriting the sick role as she (and others) interpreted it, but also its malleability when confronted by the challenges of Christian submission. “ The School of Long Affliction”: Ellen Chadwick’s Illness as Christian Education Unlike many of the invalid authors examined thus far, Ellen Chadwick left a relatively substantial biographical record. The work first attributed to her, Weak, Yet Strong, combines autobiographical and biographical narratives with Chadwick’s commonplace book selections, testimonies from her friends, and newspaper clippings about her. Echoes from a Sick Room was composed almost exclusively of “annual testimonies,” inspirational messages Chadwick wrote each year on her birthday. Both texts were then collected by H. B. Harrison in Ellen Chadwick: The Famous Manchester Invalid, a book that he claimed prompted “many Christian friends to visit the ‘patient sufferer’” and that enabled Chadwick’s story and message to inspire fellow sufferers in Britain as well as in America (3). Claiming to have gotten the idea for the title of his collection (The Famous Manchester Invalid) from a Manchester daily paper, and speculating that “Ellen was more famous than the inventor of the title could have knowledge of,” H. B. Harrison stressed with unbridled enthusiasm the sickroom as the point of that fame’s origin: Her fame was by no means limited to Manchester, nor yet to Lancashire, or even to England. Only her close and intimate friends, those who knew something of her Christmas dispatches and correspondence, etc., could fill in the meaning of the word. The Famous Invalid would have been more expressive; still, she loved her invalid life in the great City of Manchester, and from

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her little remote chamber, hidden away at the end of a cul-de-sac, her fame reached out to the utmost boundaries of the city, and then away, away, beyond. (115)

Harrison’s aggrandizing rhetoric and attention to Chadwick’s enclosure within her sickroom may seem disproportionate to his subject, but he captures many inconsistencies inhering in the figure of the invalid as embodied by Chadwick—a figure associated with the secluded and interior yet also with public recognition and influence; a figure embodying oppositional impulses, the reclusive and the exhibitionist; and a figure defined by bodily and material conditions and yet in many cases signifying the ethereal. Subsuming Chadwick’s individuality within an identity at once anonymous and public—“the Famous Invalid”—Harrison reminds us that she donned the mantle of an already multivalent identity rife with performative possibility, and he links that performance to the sickroom itself. In Weak, Yet Strong, readers are introduced to a woman born on 29 September 1847 to parents presented as “earth’s humble poor” (6). Significantly, Chadwick dates the point at which her “health . . . gave way altogether” to a time soon after her conversion to Methodism (in 1861). She “was brought home from the mill in such a weak and helpless condition, that from this time [she] was never again able to work for the bread that perisheth.” “I seemed to have a presentiment that I should either die, or be laid upon a sick bed for a very long time” (9). Chadwick’s “presentiment” proved only too true, for she spent the next forty-one years confined to a sickroom. In Weak, Yet Strong she describes the intense back pain that ensued shortly after her first collapse and reports that the “medical men” consulted discovered a spinal cord injury and “pronounce[d] the case incurable” (9). This becomes Chadwick’s defining moment: “When this sad news was announced to me my heart was bowed with grief, because I feared I should now become a burden to my parents; and as I was the only one left out of a family of eight children, I thought it would be a great trial to them to have their only child an invalid” (9–10). Her bodily sufferings only adding to the “many other anxieties” that stemmed from her “father being addicted to drink,” Chadwick nevertheless found that she could alleviate that sense of burden by becoming an exemplar of Christian submission. In this sense, Chadwick’s invalid identity could subsume other components of her identity, particularly those that she links, if implicitly, to her working-class family. Buttressing Chadwick’s own narrative with a wide range of texts written about or to her, the works collected

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within Ellen Chadwick: The Famous Manchester Invalid document in extraordinary detail Chadwick’s self-fashioning as Christian invalid. This process was inextricably linked to her sickroom itself, which centered on the image of her bed, emblematic of immobility and yet glorified as a site of spiritual transformation. Harrison warns that visitors would find Chadwick physically weak, but he counsels readers to take consolation from an understanding that her corporeal change signifies Chadwick’s “deeper, wider, richer, experience of the deep things of God” (4). Her establishment has never been closed, but many improvements have been effected. The first thing such a visitor would miss would be the large old four-post bedstead, which was Ellen’s companion for so many years. Its chief characteristics were, heavy, hard, ancient, large. This has been substituted with a more up-to-date resting place, and the corner, which used to look somewhat heavy and dark, has been considerably brightened. Gas, which has been substituted for paraffin oil, has brought Heaven nearer. The silvered over-mantel (in a fictitious way) has made the room larger. These and other changes have made the cage more worthy of its occupier. (3–4)

The virtual visitors addressed in Harrison’s introduction become part of a symbolic community of people, both healthy and suffering, brought into more tangible contact with Chadwick and presumed to be influenced by her, one of the first of many signs that the Christian invalid’s agency was not so wholly erased as the rhetoric of resignation might imply. Weak, Yet Strong, for example, includes a poem titled “Silent Sundays” that was said to have been “composed and written for Ellen by another sick friend, living in Manchester.” Describing its author as “a great sufferer for long years, who, in addition to an unpleasant disease in the flesh, is quite deaf, not having heard a human voice for many years,” the poem concludes with a brief note that reads, “composed while thinking of your lonely condition, Sunday, October 22nd, 1882” (33). The rhetoric here is significant, in part because it illustrates Chadwick’s own strategies: though she is incapacitated, Chadwick’s body and being are alike credited with a symbolic power sufficient to enable others to exert themselves. The representational strategy reminds us of agency’s capacity to denote not just the ability to exert power but also the person or thing through which power is exerted or an end achieved. Posited as tributes to Chadwick’s character, such moments also clearly capture testimony’s dual function—to affirm and to advertise. Among the many other “testimonies” included in Weak, Yet Strong is one

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from a “Miss Rigby,” identified as “one of Ellen’s very dear friends and scribes,” who writes: “I became personally acquainted with Miss Chadwick in the spring of 1883. On my first visit to her, I remember being much struck with her calm resignation, and wondered that one so afflicted and shut out from the world could be so submissive and cheerful; but soon I learned that the secret of her happiness was the sustaining power of divine grace, which she possessed” (53). Rigby’s language is worth stressing, for by representing Ellen Chadwick as submissive and yet in possession of a sustaining power, she identifies the complex way invalidism could be premised on the eradication of agency while substituting a surrogate, if equally intangible, form of capacity. Sympathizing with her “helpless condition,” Rigby evidently enlisted herself as “scribe,” writing some of the many letters and “Christmas dispatches” that Chadwick dictated from her sickbed and solidifying the image of the invalid as an intermediary straddling the passive and the active. As Harrison’s volume proceeds, the significance of visitors to Ellen Chadwick’s sickroom becomes increasingly apparent. At one point, for example, he notes, What an interesting picture gallery the varied types of character who visited Ellen’s chamber, if drawn by a mat hand, would present, all moved by the same sympathetic spirit, but expressed in so many varied forms. From roadmen, nightmen, sweeps, carters, policemen, travellers, merchants, clergy, ministers, factory girls, warehouse girls, shop girls, business people, from the healthy and wealthy, who drove to the door, to the poor cripple who had to be assisted up to her room. They all came and each contributed to the atmosphere and surroundings of the invalid’s room, and the contribution would be as varied as the numerous givers. (120)

Harrison likens the sickroom to a theater and creates a social panorama in which class differences are effaced both by the sympathetic relationship of the audience to the invalid and by the invalid’s impartial reception. In a stunning coda to this catalog of social types ostensibly united in their sympathetic stance toward the invalid, Harrison quotes from an article titled “The Queen and a Manchester Invalid” that appeared on 30 March 1900 in the Manchester Courier: “It illustrates in an unmistakable manner the kindly sympathy which Her Majesty the queen feels and manifests from time to time with regard to suffering in the humblest ranks of life” (134). In language that highlights tensions between the reclusive and exhibitionist impulses driving Chadwick’s narrative as well as her deeply rooted desire

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for authentication, he concludes that after she learned that the queen had received a copy of her book, she “felt sure she belonged to the world, and had a right to be a member of the Empire” (134). Harrison’s language here is of a piece with other dramatic and sentimental moments in the volume, all designed to make the most of Chadwick’s reach and influence as an invalid. Similar issues surface in Echoes from a Sick Room when Harrison describes the meetings conducted from Chadwick’s bed: And even in her meetings for Christians her desire was not so much for a happy meeting full of emotion as for a profitable meeting, and frequently her instructions to the leader would be “Let us have a profitable meeting”; and how often these leaders (who did not usually submit to others) would play second in Ellen’s presence, asking for her choice of hymns and her selection of the Scripture passage. . . . Increasing years and increased experience naturally led to this great proficiency. She had been a thoughtful, observant scholar, and so became an efficient and wise teacher, adviser, and friend. (126–27)

Evoking shifts in those viewed as submissive, the recollection illustrates dynamics of power played out in Ellen Chadwick’s sickroom, as in all likelihood they were in many other invalid sickrooms. The invalid author of Letters from a Sick Room begins her study with the story of another invalid, a poor cottager named Mary, and recollects how often she saw “Mary’s bed surrounded by children, collected on week days to be taught sewing, and on the Sabbath, in a little school, to learn the word of God” (15–16). “They loved her winning ways,” this author tells us, “and were never weary of listening to her pleasant voice. Important truths were made welcome to their tender minds” (16). Representing herself through her appeals for “a profitable meeting” as one selflessly motivated by the communitarian values of spiritual capital, Ellen Chadwick nevertheless usurped control of spiritual encounters in her sickroom, not simply by taking the lead in making decisions about which hymn to sing or what or whom to pray for, but also, more generally, by imbuing the sick role with characteristics more traditionally associated with preacher and prophet. Viewed through the lens of Harrison’s rhetoric, Chadwick’s strategies of self-fashioning come into focus, particularly in Echoes from a Sick Room, a work composed almost entirely of the letters she issued every year on her birthday. Chadwick’s self-fashioning in this text depends in large part on assumptions about the readers she addressed—her “beloved Friends in Jesus” or “dear Christian Friends.” In several instances

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she posits a degree of intimacy with her circumstances, as when in the letter of September 1886 she writes, “Most of you will know that for some months my mother’s health has been in a rather precarious state. Although this added to my sufferings, yet I was able to say from my heart,—‘It is the Lord, let Him do what seemeth Him good’” (62). While on other occasions she refers to her readers as “co-workers,” her recourse to phrases such as “suffer me to address a word to you” shows that she thought of herself as their supervisor as well. Much like the authors of more traditional commonplace books of consolation, Chadwick thought of her letters as producing contact beyond sickroom boundaries. Often introducing a letter with a comment such as “I am pleased to meet you all again on this memorable occasion,” she rhetorically constructed virtual visitors to her sickroom sanctuary. If Chadwick’s letters are to be believed, she had plenty of real visitors as well. At one point she claimed to “have spoken to sixty persons each week” (91), often in “meetings” or “Sunday evening services” that evidently put her into direct contact with men and women, boys and girls, from all levels of society. In her letter of September 1892 she wrote: “It has been my privilege to speak to almost all classes and conditions of society, from the lady in her carriage to the ragged-school class. This class visited me a few weeks ago; it consisted of eighteen girls. I asked them what they would like us to pray for” (81). As throughout Echoes from a Sick Room, Chadwick not only claims to feel privileged but takes full advantage of that privilege, launching into a message that wallows in a good deal of sorrow on its way to an inspirational end. “In looking back upon the past year I cannot say that it has been altogether a joyous year to me,” Chadwick writes in 1886. The next year brings a similar refrain: “It is with deep humility of soul that I recall some of my Father’s dealings with me during the past year; much suffering and trial of various kinds have been appointed to me, especially at the beginning of the year, when my bodily suffering was very severe, but He who sits as a refiner of silver tenderly watched the process lest the heat should become too intense” (64). Each subsequent letter outperforms the last. “The first six months of the year were spent in intense suffering,” she notes in 1890, claiming that she “no sooner had been lifted out of one fire than [she] was put into another” (72). The year 1892 brings “a year of weakness and pain,” filled with “many wearisome nights and days” (81). At another point in the narrative she confesses, “I feel somewhat disappointed at being here, as I thought at the beginning of the year I should have entered into the rest that remaineth

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for the people of God ere another milestone on my life’s journey had been passed” (64). If such moments in Chadwick’s letters seem tedious and self-indulgent, they also were clearly geared toward helping her advance her claim that suffering was essential to the posture of devout resignation that she sought to embody. Over and over again she concludes testimony to her suffering with some version of the following: “However, it has pleased our Heavenly Father to will it otherwise; His will is best, therefore I willingly submit to His appointment and approve of all He chooses” (64). Playing on discipline’s capacity to denote teaching and instruction on the one hand and enforced obedience and punishment on the other, Chadwick represents herself as a student of suffering: “Dear friends, why I am thus detained in the school of affliction I cannot understand, but I often think it must be for the purpose of learning more and more of my Saviour’s love to me, and the fellowship of His sufferings” (69–70). No phrase reverberates more often in Echoes from a Sick Room than “school of affliction.” “That God has a definite plan for the life of every child of His is a truth I have had to learn in the school of a long and trying affliction,” she writes in 1898 (107). A year later she concludes, “My experience could not have been today what it is had it not been for the precious lessons I have learned in the school of a long affliction” (112). In two years she would write that “for long, long years, [she had] waited and served in the school of affliction” (116). Depicting herself as “detained” and “waiting,” Chadwick taps a fund of rhetoric common to narratives organized around the experience of the sickroom, rhetoric that emphasizes the stasis surrounding invalids and the inertia they embody. Her language of learning nevertheless combines with the rhetorical emphasis on questioning, frustration, and perplexity to exert an undeniable and unsettling influence on the representation of stasis itself, rendering it as strategy and as stage, and capturing the dual connotations of that term as a station or place of rest and as a platform for performance. As a kind of imaginary way station for Christian sufferers hoping to be ushered into the promised land, the sickroom had indubitable appeal as a stage of sorts, for no matter how long invalids had to wait, they had won a reprieve from the “hustle and bustle” of everyday life, the “wear and tear” of the working world. Within their “chambers of sickness” they could compensate for the anxiety that attached to inactivity by transforming the contemplation of suffering into a kind of work. Describing the sickroom invalid as a “busy active worker” (16), M. Giles articulated the argument in Up the Hill Difficult as follows: “Yes, just because we are feeble and sick we can do

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our piece of work better than others; it is worth all the more because of the effort we have to make; we suffer, so we can sympathize with suffering, and so forth” (20). If the commonplace books that circulated among the community of Christian invalids accrued private value by seeming to bring the sufferer out of isolation, their public value rested on the fact that they made tangible this idea of sickroom work. Moreover, their conventions perfectly suited needs mandated by Evangelicalism’s emphasis on atonement, for through them invalid authors could publicly expiate their sins and help to secure salvation. In this sense the sickroom—despite, or perhaps because of, its associations with detention and imprisonment—granted another, equally powerful form of reprieve. Whereas modern medicine posited a body-focused model of disease over which the sick had little control, Evangelical discourse —substituting sin for disease and soul for body—granted far more power to the afflicted. This discourse engaged with the conventions of commonplace literature so as to subordinate an afflicted person’s sense of individuality to the scripted identity of the Christian sufferer, but that identity nevertheless afforded substantial compensatory opportunities for self-fashioning, as Ellen Chadwick’s story makes abundantly clear. Ellen Chadwick inherited and adapted a rhetoric of resignation that pervaded a literature of Christian invalidism whose distinctively Evangelical roots extend back to the century’s beginning. But she belonged squarely— as her dates confirm—to the latter part of the century, a time associated in more than a few social histories with a “medical reign of terror” in which hysteria erupted as the logical conclusion to a cult of invalidism.9 As Janet Oppenheim has summarized it, “The contention is now almost unquestioned among feminist scholars that middle-class Victorian women subconsciously turned to illness to vent their rage against limited, unsatisfying lives, devoid of personal significance and imposed on them by the tyranny of a male-dominated society” (225–26). Oppenheim goes on to convincingly combat this “rebellion hypothesis” on several grounds, not least because it appears to confirm the Victorian medical equation of femininity and sickness.10 Thanks in part to the influence of Charlotte Perkins Gilman’s story “The Yellow Wallpaper,” many today have inherited a haunting image of the 9. See especially The Female Malady: Women, Madness, and English Culture, 1830 –1980, in which Elaine Showalter sees “The Rise of the Victorian Madwoman” (the title of chapter 2) as “one of history’s self-fulfilling prophecies” (73). 10. Diane Price Herndl provides a useful assessment of various feminist approaches to illness in the introduction to Invalid Women: Figuring Feminine Illness in American Fiction and Culture, 1840 – 1940. See esp. 5–8.

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nineteenth-century woman.11 She is bedridden, enraged, and powerfully subversive despite her submissive posture in the sickroom, a space memorably described in Gilman’s text as both prison and nursery. Ellen Chadwick’s story suggests that this received image needs considerable rethinking. If women invalids took their cues from the various discourses that demanded and even validated their suffering, many nevertheless found themselves enabled within (or by) the sickroom space to reinterpret resignation and, in doing so, to manipulate ideologies of gender, health, and Christian identity to create for themselves what Ian Hacking would call “possibilities for personhood.” 11. Although Elaine Showalter, like many feminist critics before her, sees Gilman’s story as “a powerful polemic against Mitchell’s methods” (141), she shows it to be distinctly American through an enlightening comparison to the “English version of the rest cure” detailed in Elizabeth Robins’s novel of 1905, A Dark Lantern.

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“THE RANGE OF OUR VISION” Self, Surveillance, and Life in the Sickroom

You can see further from a prison cell than the top of a mountain. —Harriet Martineau 1 Invalids have ever been called egotists, and none but those who have experienced some of the joys and sorrows peculiar to this class can appreciate their story. —Letters from a Sick Room

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n March 1844, having recently completed Life in the Sick-Room, Harriet Martineau explained to a friend that she understood it to be her duty to “suffer for other people’s information,—to be a sort of pioneer in the regions of pain, to make the way somewhat easier,—or at least more direct to those who come after.” 2 With characteristic confidence, she implied that her work could function both as a manual of sorts and as a kind of social science; she claimed in essence that her sickroom stint had enabled her to produce from her own suffering knowledge that could be put to practical use by her readers—other sick people and those who cared for them. With chapters on subjects such as “The Transient and the Permanent in the Sick-Room,” “Sympathy to the 1. Harriet Martineau is purported to have made this statement during a trance in 1845. It is quoted in R. K. Webb’s biography, Harriet Martineau 252. Writing of Martineau’s mesmeric states, he observes that “she talked a great deal about suffering, about pressing ahead without stopping for it” (252). 2. Harriet Martineau’s letter to Mrs. Romilly. HM to Mrs. Romilly, 9 March 1844, MS Autogr, d.21, Bodleian.

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Invalid,” “Temper,” “Becoming Inured,” and “Power of Ideas in the SickRoom,” Life in the Sick-Room staked out territory markedly different from books by invalids that, while similarly based in the sickroom, used that scene primarily to offer Christian consolation to their fellow afflicted. Concerning herself with the psychology of the invalid, Martineau envisioned an audience less in need of consolation than of education, and she set out to produce a text to accommodate that need. Harriet Martineau was something less of the pioneer that she imagined, for although arguably the most influential and widely read of this type of invalid narrative, Life in the Sick-Room was only one of an array of texts written in the nineteenth century that sought to identify and depict the distinctive psychological attributes of the chronically ill or bedridden. This chapter examines a series of invalid narratives that foreground the idea of the invalid’s mind and the invalid’s habits of self-contemplation, making them central to the representation and meaning of invalidism itself. Rather than simply inhabit and perform a sick role, in other words, these authors made that role the subject of their narratives. Whether in poems such as William Ernest Henley’s In Hospital or in essays such as Charles Lamb’s “The Convalescent,” Alexander Shand’s “The Pleasures of Sickness,” Wilkie Collins’s “Laid Up in Lodgings,” and George Whyte-Melville’s “A Week in Bed” or in books such as the anonymous Letters from a Sick Room and Martineau’s Life in the Sick-Room, many invalid authors found themselves compelled to detail and explore the possibilities of personhood experienced by those isolated by illness. The geographic imaginary of the nineteenth-century sickroom had an invalid at its center. This figure was endowed with unique powers of observation and insight, powers that seemed naturally to furnish the tools for psychological study. As Harriet Martineau wrote, “We may be excluded from much observation of the outer life of men; but of the inner life, which originates and interprets the other, it is scarcely possible that in any other circumstances we could have known so much” (Life in the Sick-Room 211). While few invalids brought to their sickroom study Martineau’s confidence and sense of authority about their powers of observation, many shared her belief that the experience of extended illness and the culture of the sickroom, with its “round of pleasures and amusements peculiarly its own,” as George Whyte-Melville wrote in “A Week in Bed” (327), combined to produce a subjectivity unique to the invalid—and worthy of public attention. Although by the turn of the century the “rest cure” would be associated with the specific form of treatment for nervous exhaustion developed by S. Weir

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Mitchell, invalids throughout the nineteenth century described in great detail their own experiences with rest, retreat, and confinement.3 Despite variations produced by the conventions of genre, to say nothing of the considerable differences in the medical situations of individual authors or of the sociohistorical contexts in which they produced their works, many of these invalid authors used similar tropes and rhetorical strategies to represent the figure’s psychological interest. Emphasizing the separation of the sickroom from the household and society more generally, they constructed invalids as figures whose solitary place and perspective —lives “lived on one’s back / In long hours of repose,” as Henley put it in In Hospital (10)— equipped them with mental capacities unknown to the healthy, active, and working. Yet if invalids believed themselves to be privileged (or in some cases saddled) with unique powers of perspective and “range of vision,” their experience with the solitary confinement the sickroom—evocatively referred to in some works as a “gaol of weakness”—was not unproblematic. The uneasiness attached to their position both within the household and within society more generally is nowhere more evident than in the tropes of the sickroom as prison and the invalid as prisoner that are ubiquitous in much of this literature (Harriet Martineau described herself in her autobiographical memoir as a “prisoner to the couch”). Indeed, the repetition of these and other metaphors of confinement within discourse about “life in the sickroom”—that is, the extraordinary emphasis on the solitude of the sickroom and the obliviousness of the invalid within it to life beyond the sickroom’s walls—attests to the complicated symbolic relationship between the sickroom and the broader household and societal economies from which many invalid authors so anxiously sought to distance themselves. Published in popular British and American middle-class periodicals such as Fraser’s Magazine for Town and Country, Once a Week, Cornhill Magazine, and Scribner’s, essays by invalids routinely treated their readers to pages and pages describing sickroom existence, what A. B. Ward called “The Invalid’s World.” While many of these authors—much like those who compiled books of Christian consolation—assumed that the sickroom both demanded and was conducive to resignation on the part of the invalid, they were far more ambivalent about the ideal of resignation than were authors of Christian commonplace books. They typically depict the space of the sickroom less as a spiritual sanctuary, a temporary way station for the in3. S. Weir Mitchell’s own essay, “The Evolution of the Rest Treatment,” provides the most succinct overview of the various cases (dating from the 1870s) that prompted his particular form of treatment, which involved a combination of seclusion, massage, and the application of electricity.

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valid en route to eternal life, than as a tangible unit of the household. In “Laid Up in Lodgings,” Wilkie Collins’s discussion of the invalid’s distinctive preoccupations and self-centeredness is framed by a detailed description of his apartment building, what he calls his “own independent, solitary, miniature mansion” (202). Readers are led first through the drawing room into the bedchamber, where they are greeted with an account of his “little druggist’s stock-in-trade of physic-bottles, glasses, spoons, card-boxes and prescriptions” (203). The anonymous author of “Bachelor Invalids and Male Nurses” explains his abhorrence for the “formality and decorum” of sickroom behavior by noting that not only does he find “conversation carried on with bated breath, or in shrill whispers” to be “not soothing but depressing,” but that “it makes one feel out of the world to lie upstairs, and to hear, when temporarily excluded therefrom, the distant sound of the going and coming below in which one usually participates” (318). Deemphasizing (but not obliterating) the sickroom’s status as spiritual sanctuary, and downplaying (but not entirely eradicating) the ethereal nature of the invalid, these invalid authors might be said to have domesticated invalidism. In a range of ways that this chapter will study, their inquiries into the invalid’s mind, habits of self-contemplation, and distinctive subjectivity simultaneously mobilized a critique of key assumptions underpinning that very domesticity. Charles Lamb’s “The Convalescent,” Harriet Martineau’s Life in the Sick-Room, and several essays from later in the century (e.g., A. B. Ward’s “The Invalid’s World,” Wilkie Collins’s “Laid Up in Lodgings,” and George Whyte-Melville’s “A Week in Bed”) provide particularly detailed and compelling models, but to appreciate the ways that these very different works represented the invalid’s mind we need to situate them within the broader canvas of “life in the sickroom” writing. Mapping the Invalid Mind For many invalid authors, the subject of life in the sickroom was best broached via observations on the invalid’s external environment and daily routine, and their essays present themselves as ethnographic studies of the microculture of the sickroom. Not unlike the role of the participant-observers in classic ethnography, many invalid authors used their own immersion in the sickroom to legitimate broader generalizations about the sick person’s “culture.” Gillian Thomas attributes the “great strengths” of Life in the SickRoom to Martineau’s “ability to generalize and derive insights from her own experience” (175). Focused largely on the everyday and the material, such essays typically described invalids’ daily routine, offered commentary on

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Figure 21. “From the Sickroom Window,” from Harriet Martineau’s Autobiography. 1877.

their interactions with physicians, nurses, and visitors, and articulated beliefs about the value of particular “employments” and “amusements” within the sickroom. In book-length studies of the invalid’s life, these observations often merge almost imperceptibly into advice, offered both for the suffererreaders and for their caretakers. Thus, for example, Harriet Martineau stressed the importance of “the best kind of view for a sick prisoner’s windows” (Life in the Sick-Room 60) (fig. 21), and the author of Letters from a Sick Room discoursed about the value of children as “an inexhaustible source of amusement and instruction” to the sick person (63). In just such a spirit of friendly counsel C. Howard Young offered “a few lines of advice about nurses” in his Sunny Life of an Invalid: The most important thing, however, is that the nurse should be gentle, of a sweet disposition. There is a worse thing to be met with than dirt, and that is the soil on one’s soul, produced by impatience in a nurse or in one’s self. It is a positive fact that men prefer a slovenly woman to an impatient woman, even to marry. So, too, will an invalid, after he has had some experience, prefer a nurse who is gentle, rather than over-tidy. Let the invalid please himself, when possible, in the choice of a nurse, and not his relatives or friends. (153–54)

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Generalizing as they do about the invalid’s needs and requirements, such remarks expose the tendency of this type of narrative to represent invalidism as subsuming other dimensions of the person’s identity. The authors present with confidence their claims for what “the sick prisoner” needs, how much “the sick person” should be told, and what “an invalid” desires. Many authors introduced the idea of the invalid’s mind-set and temperament through mundane, everyday topics, as when George Whyte-Melville wrote in “A Week in Bed” that “everybody who has been ill knows that the doctor’s visits are succeeded with great regularity by alternate fits of elation and depression. Tuesday he leaves you buoyant and hopeful, Wednesday resigned but despairing, Thursday better, Friday worse, and so on” (330). Typifying rhetorical strategies used by many of his fellow invalids, Whyte-Melville uses the second-person “you” to generalize from his own experiences to a broader range of fellow sufferers. As important, Whyte-Melville and others render the fundamental inertia embodied by the invalid by representing the figure’s psychological state as at once fluctuating and predictable. This is the view proffered in Alexander Shand’s portrait of the “chronic convalescent” as one who was “never well; tolerably sanguine on the whole; generally feeling himself better in a series of fluctuations where the ups predominate over the downs” (551). Many invalid authors used this feature of the invalid’s position as a basis for probing more deeply the psychological experience of being ill (or being identified as ill). They represented life in the sickroom not as a study of the invalid’s routine and daily interactions but rather as an inquiry into issues of temperament, disposition, and mentality. Although focused on the more clinical space of the hospital room, William Ernest Henley’s In Hospital is applicable in this regard. Having long suffered from tubercular arthritis, Henley identified himself as an invalid long before he traveled to Edinburgh to begin a period under the care of Joseph Lister at the Edinburgh Royal Infirmary. Charting his experiences as a patient, Henley’s In Hospital depicts the “mattress life” of patients generally and his own subjective experience more particularly; many of the individual poems in this series shift interest from the clinical environment and interactions with caretakers to the patient’s interiority—what is described in the poem “After” as the “immense, complacent dreamery” of the sufferer’s mind (9). Like Henley, other invalid authors who were invested in these narratives of interiority anatomized and made taxonomies of the sufferer’s modes of thinking, particular mental capacities and powers, and general outlook on life. The social and medical dimensions of invalidism converge in representations of the figure’s psychological interest, a focus that in turn seems to

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have promoted a form of social commentary. Many invalid authors routinely extolled the sense of freedom that came with their reprieve from the daily realities of the workaday world—what Martineau called “the ordinary toil and hurry of existence” (Life in the Sick-Room 77). Appropriating the trope of freedom from society to enhance her Christian message was the author of Letters from a Sick Room, who explained the “blessings” of the invalid’s life as follows: “We are not exposed to the temptations of the busy world, though Satan is ever present, suggesting rebellion, impatience and unholy desires. Active duties, we know, are not required of us, for God never requires what it is not in our power to perform. Social obligations are not devolved upon us, but we have much time to cultivate a spirit of prayer, and we are assured that ‘the fervent effectual prayer of the righteous man availeth much’” (52). Invalids less committed to cultivating “a spirit of prayer” were no less likely to contrast life in the sickroom to the working world. Finding that his sickroom stint had provided him with “time to consider the future, as well as to reflect upon the past,” Whyte-Melville explained, “A week in bed, you see, makes you ponder over many things which escape you in the hurry and turmoil of every-day work” (334). Wilkie Collins ruminated that he “never knew what it was to enjoy the desolate liberty of the bachelor until [he] became an invalid” (199). In these comments, too, one apprehends the appeal of this narrative perspective to invalids performing quite different sick roles—whether Christian invalid, bachelor invalid, or businessman invalid, the assumption is that the sickroom has provided a necessary reprieve to contemplate one’s mental state. The frequency with which invalids framed their studies of life in the sickroom by reference to its separation from the hurried life and strife of the working world is striking and is suggestive of an anxiety not just about the competitiveness of commercial life and societal demands from which they had retreated, but also about the viability of maintaining distance from that world. When in “The Invalid’s World” A. B. Ward praises the “allembracing, all-sustaining influence of the nurse” by claiming that “by her interference the wheel runs smoothly, the outside world keeps its place, and every need of the small inner world is met and covered” (67), something of this uneasiness surfaces. Yet most invalids could not count on nurses to keep the anxieties of the wider world at bay. One Christian Examiner reviewer, identified only as “E.Q.S.,” characterized the invalid: “In his feverish dreams he resumes suspended tasks, stands at the wonted desk and writes, makes sales, calculates accounts” (166). This reviewer’s depiction of the invalid unable “in feverish dreams” to escape the pressures of professional life is especially interesting in that Martineau’s Life in the Sick-Room was the subject of

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the review. Although men and women clearly experienced “life in the sickroom” and sought in their narratives to represent it, the space was indubitably feminized, associated not only with a passive and submissive posture but also with the nurturing and “all-sustaining” influence of the (maternal) nurse. The overworked businessman described in the Christian Examiner is thus a patient who, in some respects, is most able to appreciate and benefit from the sickroom experience. Emphasizing the sickroom as a retreat from social and economic pressures, many invalids took to its extreme domestic sphere rhetoric of the home as a haven. They not only portrayed the sickroom as a sanctuary within that home but also depicted the invalid as occupying a static or fixed position that was in sharp contrast to the flux associated with both the market and social life and that mimicked the activity associated with household management. Nevertheless, the multiple references to the layers of enclosure that surround invalids and hence “fix” their position within the home hint at the claustrophobia of their “inner world,” depicted in Ward’s essay as a sanctum within the already cloistered space of the sickroom. In some instances invalids represented the home’s boundaries as distressingly penetrable, with the demands of the market and pressures of class advancement being replicated within the household economy and signified by references to the hustle, bustle, and household noise that threaten to disrupt their environment. Ever aware of the busy world from which she was sequestered, the invalid author of Letters from a Sick Room was equally cognizant of the activity that surrounded her within the domestic sphere. “But I have witnessed scenes far different; where the morning slumbers, the hurried toilet preparations and household bustle, prevented the possibility of entering the closet, or kneeling at the family altar,—where he whose duty it was to feed souls famishing for the bread of life, himself fed on that which satisfieth not,—the husks of the world” (130). Many invalid authors defensively proclaimed themselves impervious not simply to the outside world but also to the preoccupations of household management. As Charles Lamb wrote in “The Convalescent,” “What passes out of doors, or within them, so he hear not the jarring of them, affects him not” (267). Like many of the invalid authors who followed him, Lamb’s representation of the invalid’s psychological interest depends on crucial assumptions about the relation of the home —and the sickroom within it—to the market economy that surrounded it, as well as to the sickroom’s place within the household and the invalid’s place within the sickroom. If invalids took to their sickrooms as a response to pressures associated with the wider world, they exerted their own pressures on the household.

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Lamb attributes “the spell that hushed the household”—“the desert-like stillness, felt throughout its inmost chambers, the mute attendance, the inquiry by looks, the still softer delicacies of self-attention”—to “all that made sickness pompous” (271). Wilkie Collins describes one of the maids-of-allwork in his lodgings this way: “Number One is amazed by the spectacle of my illness, and always stares at me” (225). George Melville-Whyte’s many references to his wife’s bustling about on his behalf, attending to his comfort “in the highest possible spirits and good humour” and keeping the children “at skirmishing distance” so that he could take his breakfast and read the paper undisturbed testify to the obvious delight he took in the idea of being the protected object of all that attention (328). Most invalid authors, however, were blissfully oblivious to their impact on the household, choosing instead to depict the solitude and silence that surrounded them as the natural environment of the sickroom and one especially conducive to introspection. Describing her life in a sickroom to a friend, Elizabeth Barrett Browning wrote: “Flush’s breathing is my loudest sound, and then the watch’s tickings, and then my heart when it beats too turbulently” (qtd. in Hewlett 100). Invalids routinely praised the sanctuary-like quality of the sickroom, claiming that it ensured unparalleled opportunities for self-examination and reflection that were anything but indulgent. Harriet Martineau evocatively called the sickroom “a natural confessional, where the spontaneous revelations are perhaps as ample as any enforced disclosures from disciple to priest, and without any of the mischiefs of enforcement” (Life in the SickRoom 196). Invoking a similar metaphor, Frances Power Cobbe described the intensity of one of her friendships this way: “I often said that I went to church in her sick-room” ( Life of Frances Power Cobbe 1: 524). The association of the sickroom with sacred space operates in different ways in “life in the sickroom” narratives, sometimes affirming the room’s affiliation with prostrate, submissive posture and with feminine ministry and sometimes providing an ironic counterpoint to the sardonic wit of the temporarily house-bound, convalescent businessman. With little to do but accept the solicitations of visitors and those in charge of care, many invalids felt obliged to monitor their every sensation and to analyze the impact of their sickroom solitude and isolation on their minds. Spurred by the desire to make these opportunities for contemplation “useful” and “profitable,” and generalizing from their experiences to those of their fellow sufferers, the most earnest among them wrote works exploring the invalid’s attitude toward such topics as the sympathy of others, the sensations of pain, becoming inured to suffering, the contemplation of nature,

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and the necessity of accepting death. So often rendering life in the sickroom by moving from details of invalids’ surroundings and routine to analysis of their habits of mind, these narratives illustrate an overlapping of psychological and sociological inquiry in popular literature in the years before these nascent fields of study emerged in their distinctive modern forms. Perhaps because of their mutual understanding of the sickroom experience as having a profound effect on the invalid’s mind, many narratives devoted to life in the sickroom share with the Christian commonplace literature an emphasis on the ideal of resignation. For Elizabeth Squirrell, as for others, the notion of resignation went hand in hand with the domestic ideal. After describing her stay at Ipswich Hospital, she wrote, “I returned home physically weaker than when I went. I felt unspeakable joy at being once more in the bosom of home, and abandoned all hope of recovery. I thought to suffer quietly a few weeks, and then peacefully to bid adieu to every earthly sorrow; but I was destined to no such tranquil and speedy deliverance” (27). Deploying the conventions of spiritual autobiography, Squirrell’s unusual work ends with a defense of the visionary powers she believed she had acquired in the sickroom. To get to that narrative end, she provides a “retrospection” of her illness and describes the many “alarming states” that she experienced “in the gaol of weakness” (17). The narrative does not end with recovery but rather traces a trajectory of decline. For many invalid authors, the liminal qualities of invalidism were most effectively represented through narratives with nonlinear, nonchronological formats that stylistically reinforced the invalid’s thematic challenge to the ideals of recovery and resolution. In this respect, Henley’s In Hospital illustrates the significant differences between the more clinical experience of the hospital and the domestic experience of the sickroom. The poem begins with the lyric “Enter Patient” and ends with one titled “Discharged.” Within this frame, additional dimensions of the patient’s experience are presented in linear fashion—for example, “Before,” “Operation,” and “After.” Rather than chronicle the experience of the sickroom from beginning to end, most invalid authors organized their narratives around thematic ideas —dimensions of the invalid’s experience within the world of the sickroom. For some this experience was best rendered through aspects of the daily routine such as “doctors,” “nurses,” and “visitors.” For Whyte-Melville, the invalid’s “round of pleasures and amusements” (327) provided a way to structure experience. Still other invalids sought to organize their insights around aspects of the invalid’s contemplative life, such as “sympathy,” “nature,” and “pleasures and pain.” Collins’s “Laid Up in Lodgings” ends with

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the narrator indicating that he is soon to leave his urban environs for a stint in the country, there to try to regain the health he has been unable to achieve in the sickroom. Resisting a narrative model directed toward recovery, reintegration, and resolution, these works thus structurally depict the invalid as fundamentally static and immobile and thus reinforce their presentation of the invalid’s psychological inertia. These two representational strategies are captured especially well in the recurrent motifs of waiting, watching, and lingering that percolate throughout life in the sickroom narratives. “I am loitering, longing, dreaming,” wrote Henley in the In Hospital lyric titled “Music” (35). For the author of Letters from a Sick Room, the life of an invalid was a God-ordained “state of probation” (16). And in Life in the Sick-Room Harriet Martineau envisions the perfect kind of visitor, one who consoles the invalid not by reminding her of her high spiritual calling but by saying, “Lift up your head amidst your lot, and wait the issue —not submissively, but heroically” (46). The invalid that Martineau and others construct is almost always on the alert—watching, observing, listening, and thinking. Ward describes the “invalid looker-on” this way: “He has heard the warning bell of the ambulance, and he watches, from behind his curtains” (“Hospital Life” 711). “We, who for a long time are accustomed to watch the minutest operations of nature, learn to look upon every scene within the range of our vision with peculiar interest and affection,” wrote the author of Letters from a Sick Room in language that might as easily have appeared in Martineau’s text (96). Taking the same idea to its pathological extremes, in the lyric “Nocturn” Henley wrote of being awake at midnight and hearing a cistern leaking: Like the buzzing of an insect, Still, irrational, persistent . . . I must listen, listen, listen In a passion of attention. (41)

The repetition here helps to convey a sense of the invalid’s compulsive attentiveness, his submissive posture within the clinical setting inducing an inescapable and maddening feeling of being perpetually “on alert.” Although few invalids felt, like Henley, that the watchfulness cultivated in the sickroom bordered on or conspired to produce madness, many shared

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his preoccupation with the unclear boundaries between healthy and unhealthy perspective. Waiting, watching, and lingering were all ways that the invalid stationed within the sickroom could render the experience as “active.” The language points to the unique way that invalid authors attached agency to an experience largely defined by confinement and submission. Kin to these motifs was the more medical one of “becoming inured to pain,” a favorite topic of invalids attempting to represent life in the sickroom. Writing of the difficulty, but necessity, of becoming “inured to pain” was the author of Letters from a Sick Room: It is so long since we have taken pleasure in the active employments of those about us, that we almost cease to realize what they afford. But no length of duration can so inure us to extreme pain that the fear and dread of the returning periods is not ever upon us. We may occupy the mind, and devise amusements, we may take an interest in the affairs of others, a knowledge of passing events in the world, may keep up a wholesome excitement, but I cannot conceive how things like these can produce perfect resignation to such a state as ours. (50)

Only a sanctified heart and Christian spirit, she goes on, can ensure the patience and “true” resignation that the invalid is supposed to embody.4 Although many invalid authors used different grounds to articulate the privileges of affliction and to represent the pleasures and power of submission, they similarly depict the invalid as a figure “resigned” to life in the sickroom. More than a few approached this dimension of their subject ironically, finding in the invalid’s posture of resignation an opportunity to explore and exploit the idea of self-absorption. As the author of Letters from a Sick Room wrote, “Invalids have ever been called egotists, and none but those who have experienced some of the joys and sorrows peculiar to this class can appreciate their story” (39). Lamb’s essay “The Convalescent” is one of the earliest examples of a type of narrative appearing at various points throughout the century that treats satirically the invalid’s self-centeredness, 4. Both the tone and the substance of this author’s message here suggest that Letters from a Sick Room belongs more to the province of materials traversed in chapter 4. The author advocates many of the same sources of consolation as did her fellow Christian invalids, but her purpose is less to console other invalids than to educate the healthy and the sick about the invalid’s life. She intersperses consoling thoughts throughout the narratives, but the book structures itself not as a compilation of inspirational messages—that is, as a commonplace book—but rather as an analytical study of the invalid’s world.

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what Wilkie Collins called the “sick man’s involuntary egotism” (214) (fig. 22). Whereas some Christian invalids argued that self-examination could enable release from self, Lamb and some of the others who followed his lead suggested that self-scrutiny leads only to, well, more self-scrutiny. The “lucky malade imaginaire” is one who “takes out by way of prescription a fresh lease of existence,” Alexander Shand wrote in “The Pleasures of Sickness” (548). “Thenceforth he has an object, and, what is better, an object that is strictly personal” (548). Writing that “by the time you have been a week in bed your habits have become those of a man who is crippled for life,” Whyte-Melville explained, “You like to dwell on your grievances, and to be pitied by your visitors; but you are, nevertheless, tolerably resigned and easy, and altogether wonderfully comfortable” (335). Whyte-Melville’s tone conveys a kind of easy acceptance of the invalid’s preoccupation with self— an assumption that it is little more than a foible of the afflicted. Not all invalid authors found it quite so easy to laugh off, and their narratives reveal a surprising array of rhetorical strategies designed to represent—and contend with—the invalid’s interiority, some attentive to gendered identity and others more invested in capturing invalidism’s power to subsume identity. Charles Lamb’s playful essays on the subject—written for London Magazine in July 1825—are especially interesting studies of early nineteenthcentury understandings of and approaches to “the sick role.” In these essays Lamb’s own identity is replaced first by use of his essayist name “Elia” and then again when that persona is displaced rhetorically by broad categories such as “the sick man” and “the convalescent.” In its sophisticated handling of tensions between the impulse to produce and the desire to disengage and “become insensible to all the operations of life” (Essays of Elia 267), Lamb exposes just why later writers would find invalidism, however threatening its association with egotism, a powerful model of identity in a world increasingly identified with the energetic devotion to work both trumpeted and seemingly mandated by industrial and self-help cultures. “A World unto Himself ”: Charles Lamb’s Convalescent The January 1823 issue of London Magazine contained a short essay titled “A Character of the Late Elia. By a Friend.” Intended as a sort of epilogue to the collected Essays of Elia, which had just been published, Lamb includes in it a witty defense against the charge of egotism that provides important insight into his representation of the figure of the convalescent nearly a year and a half later. In his character study, Lamb explains, “If it be egotism to

Figure 22. “The Invalid Lodger, or How to Follow a Prescription.” Courtesy of the National Library of Medicine.

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imply and twine with his own identity the griefs and affections of another— making himself many, or reducing many unto himself—then is the skillful novelist, who all along brings in his hero or heroine, speaking of themselves, the greatest egotist of all; who yet has never, therefore, been accused of that narrowness” (Essays of Elia xix). In Lamb’s view, egotism connoted not narrowness but expanse, the freedom to take on and manipulate aspects of the experiences and personalities of others into his own sense of self, and his understanding of identity incorporated this notion of the malleability and expansiveness of character.5 Egotism and identity are the conceptual cornerstones of Lamb’s figures of the sick man and the convalescent. Although titled “The Convalescent,” Lamb’s essay distinguishes between phases of the sick man’s experience as bedridden, with “convalescence” marking the important moment in the course of illness when a return to household normality and the reappropriation of business demands commences. In language akin to that of “A Character of the Late Elia. By a Friend,” he writes that the sick man “makes the most of himself; dividing himself, by an allowable fiction, into as many distinct individuals as he hath sore and sorrowing members” (Essays of Elia 268). Near the beginning of “The Convalescent,” Lamb—writing in the role of the essayist Elia—links the idea of egotism to the solitude of the individual confined to a sickroom, which in turn is associated with a blissful lack of concern for life outside the sickroom walls. Comparing his thoughts on the subject of convalescence to “sick men’s dreams,” he explains, “And truly the whole state of sickness is such; for what else is it but a magnificent dream for a man to lie-a-bed, and draw daylight curtains about him; and, shutting out the sun, to induce a total oblivion of all the works which are going on under it? To become insensible to all the operations of life, except the beatings of one feeble pulse?” (Essays of Elia 267). Lamb’s image of the sick man enclosed within the daylight curtains and his mocking reference to the “one feeble pulse” commanding his attention underscore the intensity of his need for separation from public life and the pressures of the working world. For Lamb, who in a May 1825 London Magazine essay titled “The Superannuated Man” had attributed his own failing health and flagging spirits to the tedium and pressures of office life as well as to a haunting sense of his own “incapacity for business,” the middle-class 5. For a different interpretation of Lamb’s treatment of the convalescent’s egotism, see Howard Brody’s Stories of Sickness, 99–102. Brody reads Lamb through the lens of the philosopher Samuel Gorovitz, who argues that illness results in “an undesirable egocentricity that shrinks a sick person’s view of the world” (99).

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man of work was condemned to a kind of captivity and had “no prospect of emancipation” (Essays of Elia 282). As his language of incapacity and stagnation suggests, the businessman either was already an invalid of sorts or was condemned to becoming one. If in “The Superannuated Man” a reprieve from the pressures of industriousness and gentlemanly performance comes in the form of an early retirement, in “The Convalescent” sickroom existence provides a more temporary version of those very assurances and pleasures. Escape from one’s middle-class existence is as central to Lamb’s study. During the course of his essay, he praises the “regal solitude” of the sickroom, refers to the “bed of sickness” as a “throne,” extols the “monarchical prerogatives” of the sick, and compares the patient to lord and king. His royal analogies enable him to represent the sense of privilege that goes along with the sick role, and thus he captures the idea that sickness—not unlike the wealth of a newly industrializing nation—imposes reconfigurations of status that are —as Carlyle would put it just four years later—“strangely altering” (“Signs of the Times” 466). The sick man and convalescent imagined by Lamb is clearly someone who adopts his posture in response to distress emanating from the wider world. Lamb evidently did suffer a nervous breakdown after leaving the India House in 1825, just before writing this essay for London Magazine. He writes at the essay’s beginning that he is recovering from the “indisposition” of a “nervous fever,” and he later refers to his involvement in a lawsuit, which had him “trudging about upon this man’s errand to fifty quarters of the town at once, jogging this witness, refreshing that solicitor” and which “was to be the making or the marring of his dearest friend” (Essays of Elia 268). Thanks to a collapse of health, however, “the word ‘friend,’ and the word ‘ruin,’ disturb him no more than so much jargon” (268), and he triumphantly concludes that “to the world’s business he is dead” (269). Emphasizing as he does his movements across town, Lamb helps to stage what will become, as his essay proceeds, a critique of the social mobility that drives men to succeed in their careers. Lamb’s irony at the passage’s end is richly complex, for as much as his nervous collapse and retreat to a sickbed has enabled him to repudiate the pressures of his profession, the retreat comes at the expense of charitable feeling as well. He is “dead” not simply to “the world’s business” but also to the demands (and consolations) of friendship. Taking the isolation of the sick man one step further, Lamb exaggerates his insensibility to household activity as well: “Some faint murmur, indicative of life going on within the house, soothes him, while he knows not

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distinctly what it is. He is not to know anything, not to think of anything. Servants gliding up or down the distant staircase, treading as upon velvet, gently keep his ear awake, so long as he troubles not himself further than with some feeble guess at their errands” (269). Comforted by an awareness that “he is not to know anything,” the sick man reposes in an atmosphere free from the burdens and debilitating consequences of information and overstimulation. Lamb’s insistence on the quiet and seclusion of his sickroom, and its lack of stimulus, registers a response to commotion associated, if implicitly, with the modern market. Drawing on Thomas Trotter’s association of the modern market with “inordinate stimulation,” Roy Porter describes late eighteenth- and early nineteenth-century culture as having cultivated, in its “mobilization of consumerist expectations,” a “psychology of stimulus” (“Addicted to Modernity” 185, 190). As Porter shows, Thomas Trotter influentially associated the commercialism of his culture not simply with “accelerating the circulation of wealth, goods, and fashions,” but also with “creating an emulative environment of narcissism and competitiveness” (“Addicted to Modernity” 184). Lamb’s invalid persona enjoys his reprieve from household concerns because he is insulated from the excessive stimulation that exists outside his home but also, ironically, because he is confident that he is the household’s fixed center of attention. Lamb depicts the sick man as desperate for forms of solace and reassurance that are peculiarly domestic. His importance is ratified not simply by the presence of servants, but by the special care with which they and other family members treat him. Thus when near the essay’s end Lamb writes of the transition of the feverish and indisposed sick man into what he calls the “flat swamp of convalescence,” he renders it as the domestic equivalent of a fall from grace: “How convalescence shrinks a man back to his pristine stature! Where is now the space, which he occupied so lately, in his own, in the family’s eye?” (270). “You will confess,” he goes on, “that from the bed of sickness (throne let me rather call it) to the elbow chair of convalescence, is a fall from dignity amounting to a deposition” (270). He concludes, “‘What a speck he is dwindled into!’” (271). Through his anxious references to his family’s attention, Lamb implies that the bourgeois world of work—the market economy, with its overwhelming pressures on the businessman to perform—has divested that man of his rightful place at the center of the domestic sphere. Written in 1825, the essay reflects and responds to features of modern life traditionally associated with the Industrial Revolution—most specifically, its association of a

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masculine ethic of industriousness with financial and social success. Yet Lamb’s investigation of the sick man’s subjectivity, embedded within this more overtly social dimension of the text, renders the essay’s message far more complex. Far from simply restoring the ailing businessman to a place of healthful security and domestic ease, the sickroom sanctuary instills its own psychic disorder. “How sickness enlarges the dimensions of a man’s self to himself! he is his own exclusive object,” Lamb proclaims in an exuberant but mocking “defense” that posits the invalid as enjoying the “right” to his self-absorption. “Supreme selfishness is inculcated upon him as his only duty,” he writes in one of many statements that position the ideals of escape and duty not in opposition to one another, but in tandem (267). When Lamb goes on to write that the invalid “makes the most of himself; dividing himself, by an allowable fiction, into as many distinct individuals as he hath sore and sorrowing members” (268), his essay shifts from its satiric thrust to delve more seriously into the sick man’s subjectivity. Although poking gentle fun at an invalid’s self-absorption, Lamb grasps the idea that illness can confer on the sick person a sense of individual difference and significance and implies that this status is denied to him outside the sickroom. This perspective on illness is not unlike Michel Foucault’s point in The Birth of the Clinic that through the consumptive experience “the individual finds himself, escaping from a monotonous, average life” and that “the dull, common life becomes an individuality at last” (171). In Lamb’s formulation, the invalid “understands not what the callings and occupations of mortals are; only he has a glimmering conceit of some such thing, when the doctor makes his daily call; and even in the lines on that busy face he reads no multiplicity of patients, but solely conceives of himself as the sick man” (269). Lamb’s essay captures the infantilizing nature of invalidism when it ends by describing his transition out of convalescence as “a wholesome weaning from that preposterous dream of self-absorption” (270). Momentarily addressing the editor of London Magazine, he writes, “Your note, dear Editor, reached me, requesting an article,” a “summons” which “seemed to link me once again to the petty businesses of life” (Essays of Elia 271). Work replaces self as the object of his preoccupation. No longer a hypochondriac, a “Tityus to himself,” and “the giant of self-importance,” he informs his editor (and his readers) that “you have me once again in my natural pretensions—the lean and meager figure of your insignificant Essayist” (272). The emotional texture of this conclusion is nothing if not contradictory and echoes that of Bulwer-Lytton’s in “Confessions and Observations of a Water Patient.” Called back to duty and work, Lamb’s convalescent may

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have recovered, but his recovery nevertheless propels him back into activity rendered “petty” and situates him squarely within a social stratum that views him as insignificant. “ Wide Awake in My Watch”: Harriet Martineau’s Life in the Sick Room To segue directly from Lamb’s “The Convalescent” to Harriet Martineau’s Life in the Sick-Room might seem at first to be a leap greater than the nearly twenty years’ distance between the two works would suppose. Reflecting a late Georgian spirit of satire, Lamb approached his subject with trenchant wit and irony that stands in sharp contrast to Martineau’s unrelenting seriousness and sober moral thought. Nevertheless, Martineau operated under assumptions about the invalid’s identity surprisingly similar to those more playfully explored in “The Convalescent.” Arguably the first text to so seriously and comprehensively treat the subject of the invalid’s mind, Life in the Sick-Room —and Martineau’s subsequent commentary about it—offers insightful metacommentary on the representational challenges faced by invalids who set out to anatomize the interior world of the invalid (fig. 23). When Harriet Martineau declared it her duty “to suffer for other people’s information,” she sought to divest Life in the Sick-Room of some of its status as personal testimony and attribute to it an air of dispassionate objectivity. Many of her friends and visitors were evidently as convinced as Martineau herself of her status as heroic martyr. Mary Wordsworth approvingly described Life in the Sick-Room as “a genuine and touching series of meditations by an invalid not sick in mind or heart” (qtd. in Wheatley 232). And when Samuel Smiles wrote an essay on Martineau for his Brief Biographies, he observed that “even when laid on her bed by sickness, she went on writing, as if it had become habitual to her, and then produced one of her most delightful books, her ‘Life in the Sick-Room’” (499). The disapproval that Life in the Sick-Room garnered in some corners is revealing. Carlyle, for one, was said to have observed, “Harriet Martineau in her sickroom writes as if she were a female Christ, saying, ‘Look at me: see how I am suffering’” (qtd. in Webb 199), and the British and Foreign Medical Review decried the “morbid” vanity that generated the fundamental “unhealthiness” of the book. Most tellingly, when just a decade after writing Life in the Sick-Room Martineau wrote her autobiography—again believing herself to be dying—her attitude had so dramatically shifted that she could proclaim, “I am ashamed, considering my years and experience of suffering, that

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Figure 23. “Portrait of Harriet Martineau, by M. Bowness of Ambleside.” 1860s. Courtesy of the National Portrait Gallery, London.

my state of mind was so crude, if not morbid, as I now see it to have been” (2: 458). Although Martineau would later resume her life as an invalid, spending almost all of her later years sequestered at her home in Ambleside, at this juncture of her life she clearly wanted to place some of the blame for her invalid state of mind on an Evangelical ethos of suffering: “I am aware that the religious world, proud of its Christian faith as the ‘Worship of Sorrow,’ thinks it a duty and a privilege to dwell on the morbid conditions of human life; but my experience of wide extremes of health and sickness, of happiness and misery, leads me to a very different conclusion,” she had written at an earlier point in the autobiography (2: 439). But however much her culture might have endorsed the project, Martineau accepted primary responsibil-

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ity for its mistakes. Further excoriating herself, she fumed, “Stoical! Why, if I had been stoical I should not have written the book at all:—not that book; but if any, one wholly clear of the dismal self-consciousness which I then thought it was my business to detail. The fact is, as I now see, that I was lingering in the metaphysical stage of mind, because I was not perfectly emancipated from the débris of the theological” (2: 459). Many of Martineau’s biographers and critics have taken her assessment at face value, viewing Life in the Sick-Room as at worst an aberration, at best what Vera Wheatley has called “the swan-song of her Unitarian orthodoxy” (233). Yet by describing herself as “lingering” and associating her “stage of mind” with theological “débris,” Martineau seems intent on reminding readers of her autobiography that the text was written by an invalid and rooted in the mind-set of invalidism, one characterized as inert and stagnant. It exposed dimensions of the author’s identity that subsumed those produced or affirmed by her Unitarian beliefs. Locating the source of the book’s problems in its exposure of “dismal self-consciousness,” she identified just that dimension of the book most critical to her representation of invalidism yet most susceptible to criticism, for many, like Carlyle, assumed “self-contemplation” to be “infallibly the symptom of disease, be it or be it not the sign of cure” (“Characteristics” 72). In her autobiographical condemnation of the work, Martineau implies that she came to recognize her “dismal self-consciousness” only after the fact, but at several points in Life in the Sick-Room she grapples with the “problem” of self-consciousness, as when she writes, “The divinest souls—the loftiest, most disinterested and devoted—all unite in one testimony, that they have been best when happiest; that they were then most energetic and spontaneously devoted—least self-conscious” (148). The very qualities and focus that embarrassed Martineau as she reflected in the mid-1850s on Life in the Sick-Room were of most interest to many of the book’s first readers, both those who approved of her project and those who disapproved. Although invoking different vocabulary, Carlyle, Mary Wordsworth, and Martineau herself each identified the central interest and measure of her book as its evidence of an ill person’s mind, and this was the theme most often picked up on in the press. The damaging article in the British and Foreign Medical Review “diagnosed” Martineau’s problems as those of the mind, an indication, Alison Winter claims, of a shift from treating the text as “a body of knowledge” to “a piece of contingent evidence” (Mesmerized 221). Typifying the trend in positive reviews of the book was the Dublin University Magazine, which began by encouraging its readers to expect not a chronicle of pains and griefs or a catalog of physician’s

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visits and apothecary’s bills, but rather enlightening “trains of thought” and evidence of “thinking aloud” (Hayman 573). “In truth, the daily life of the mind is a thing too generally neglected,” the reviewer added by way of emphasis (573). Martineau did indeed structure her study around features of the “daily life of the [invalid’s] mind,” representing this interior, emotional world through discussion of sympathy, temper, and “the power of ideas,” among other topics. But this organizational strategy and focus depended on a crucial fact about more tangible features of the invalid’s experience in the sickroom, what in the chapter “Life to the Invalid” she calls “sequestration from the action of life” (77). To apprehend the minds of invalids, she implied, one must fully appreciate the difference between their solitary and sedate lives and the busy, hurried lives led by those not “privileged” to occupy the sickroom. This dimension of Martineau’s self-representation was picked up on in reviews of her work. A reviewer for the Dublin University Magazine wrote that “when laid aside from the busier scenes of life, we are in a manner constrained to this wise self-searching. The period of invalidism, which unfits us for the turmoil of active existence, seems particularly adapted for the acquirement of this hallowing wisdom” (Hayman 573). Describing invalids as those “who are not abroad in the street, and cannot go in bodily presence into the by-places of life,” Martineau gushed about the revelations available to her “in this one room” and encouraged her readers to “look into the retired places” and “the least known parts of human life” to find similar sources and understanding of “moral beauty” (Life in the Sick-Room 107). In Life in the Sick-Room she provides little overt explanation of what accounts for her “sequestration,” but the many references to the busyness of the healthy, working world combine to confirm the account provided in her autobiography, which introduces her years at Tynemouth with references to the “anxious period” (1: 437) that preceded it and the “years of strenuous work” that followed it (1: 443–44).6 Describing the former period,

6. In his Medical Report of the Case of Miss H—— M——, Dr. T. M. Greenhow quotes Martineau as having become sensible of “‘a great failure of nerve and spirits, and of strength’” as early as 1838. This report goes on to detail ailments in Martineau’s uterine region. Greenhow argues that Martineau experienced a gradual but natural recovery and attributes the seeming success of her experiments with mesmerism to “the enthusiastic mind” of his patient (24). Much of the report was made public by Greenhow himself in an article published in the widely regarded British Medical Journal, “Termination of the Case of Miss Harriet Martineau.” Some obituaries sought to vindicate Martineau from the treatment she received at Greenhow’s hands. G. A. Simcox wrote in the Fortnightly Review that “the doctors, of course, began by disbelieving in the recovery, and ended by disbelieving in the malady, which was reasonable enough: what was not so reasonable was that they insisted in believing that they had been misled by the patient who had accepted their diagnosis of her symptoms” (532).

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Martineau wrote that her “industry” and “social intercourses” were “at their height of prosperity” but that the time was nevertheless characterized by her sense of overwhelming professional responsibilities and, importantly, the domestic duty entailed in tending to a demanding and at times unappreciative mother. “Heaven knows, I never sought fame; and I would thankfully have given it all away in exchange for domestic peace and ease,” Martineau explained, “but there it was! and I had to bear the consequences. I was overworked, fearfully, in addition to the pain of mind I had to bear” (1: 441– 42). Comments like these remind us of Martineau’s status as one of the relatively rare middle-class women working in the public sphere who could creditably claim “overwork”—a diagnosis far more likely to be applied to men—as a rationale for her distress. Locating dual sources of distress— finding the pressures of her journalistic career as debilitating as the responsibilities of caring for and pleasing her mother—it is hardly surprising that Martineau found herself longing to lie down, “in solitude and silence” (1: 442), or that she “chose to live alone” (1: 445).7 One obituary writer would later liken Martineau’s move to Tynemouth to “the instinct of wild creatures that creep apart to die,” but much evidence suggests that just the opposite was true (Simcox 531). After visiting Martineau for ten days in 1842, Anna Jameson wrote to her friend Ottilie von Goethe that “she is as she described herself, ‘poor, hopelessly sick, banished from society, unable to follow her usual pursuits and perfectly happy’” (141). Although Martineau was “lying on a couch, without hope of recovery, protracted suffering and a painful death before her,” Jameson “found her not only cheerful but gay, full of interest about everything in the world, full of passionate gratitude to heaven and to her friends” (141). Securing for herself in her sickroom an environment in which “solitude and silence” could prevail, Martineau took great care to ensure that the space was both comfortable and stimulating. As R. K. Webb writes, “She grew plants, decorated the room with casts and prints, received gifts of fresh flowers and fruit; she read, and wrote, and drew, and studied Euclid, and looked out of her bay window” (194). Trev Broughton aptly describes Martineau’s “liminal view from the Sick Room” (30), an interpretation echoed by Alison Winter, who writes of it as “a liminal space whose inhabitant was poised between the passivity of the ill woman and the assertiveness of a public figure” (Mesmerized 7. For a provocative analysis of the factors that contributed to Martineau’s illness, see Diana Postlethwaite’s “Mothering and Mesmerism in the Life of Harriet Martineau,” which argues that Life in the Sick-Room, like other words by Martineau, “depict[s] the frustration and anger that drove Martineau to Tynemouth, the healing self-exploration and self-expression that occurred there, and the new balance and resolution symbolized by her Ambleside garden” (585–86).

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219). Dramatically describing her moment of entry into this space, Martineau wrote: “On the sofa where I stretched myself after my drive to Tynemouth, on the sixteenth of March, 1840, I lay for nearly five years, till obedience to a newly-discovered law of nature raised me up” (1: 443). She clearly wanted her autobiography readers to understand the appeal of sickroom stasis in view of the overwork and anxiety that characterized her frenzied professional life. Alison Winter claims that when Martineau took to the sickroom, “one of early Victorian England’s most active public figures risked being transformed into the epitome of delicate femininity, immobilized and cloistered by her illness” (“Harriet Martineau” 597); but the many sickroom narratives written by male invalids caution us against overreading associations with “delicate femininity.” Still, the consequences of her actions were considerable. Life in the Sick-Room only hints at Martineau’s previous existence through its many references to her being one of an active, busy throng of people. Writing in her dedication, “While I was as busy as any one on the sunny plain of life, I heard of you laid aside in the shadowy recess where our sunshine of hope and joy could never penetrate to you” (xiv), Martineau essentially introduced the keynote to the book as a whole. Although directing herself periodically to this unnamed dedicatee, at other points in the narrative she addresses a broad community of fellow sufferers. The technique had served her well in her “Letter to the Deaf,” published a dozen years earlier; there she explained that so addressing the community was her “only means of reaching you all” and that it enabled her to write “with the freedom which [she] should use in a private letter to each of you” (“Letter to the Deaf ” 174). Explaining in Life in the Sick-Room the variations with which invalids receive the sympathy of their visitors, Martineau imagines a “friend” of “brighter days” as one who, “busy in robust health of body and spirit,” counsels her to “endure” (46). Other visitors advise her to accept as a privilege the opportunity for leisure, “no hurry, no conflicts nor misgivings about duty” (48). As her text proceeds, the idea of being busy or engaged with work comes increasingly to signify not so much occupation as preoccupation, a mind so absorbed with the practical and everyday as to militate against more transcendent spiritual appreciation and moral understanding. Reflecting on the time “before we were laid aside,” Martineau notes that “busy and involved as we were in the interests of the day, how little use did we make of the philosophic retrospect, which might and should have been prophetic!” (80 –81). In the “hubbub of party,” many have “let go their faith,” she ruminates at another point in the text, claiming that they find that faith

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again only in “sequestration from affairs” (88). The moral superiority that Martineau confers on the invalid is inextricably linked to the sickroom’s status as an enclave, enclosed within the home and detached from the hustle and bustle of society and the (im)moral imperatives of the market economy. Here again her dedication provides illustrative commentary: While we use our new insight to show us how things are done,—and gravely smile to see that it is by every man’s overrating the issues of his immediate pursuit, in order that he may devote all his energy to it, (without which nothing would ever be done,) we smile with another feeling presently, on perceiving how an industry and care from above are compensating to every man his mistake by giving him collateral benefits when he misses the direct good he sought,—by giving him and his helpers a wealth of ideas, as often as their schemes turn out, in their professed objects, profitless. (xix)

In the sickroom “retreat,” she claims, invalids are privileged with a kind of “moral understanding” that is “little suspected by busy stirrers in the world” (105). Clearly the idea of a busy, hurried, and actively engaged world existing outside the sickroom sanctuary held enormous appeal to Martineau for its explanatory and justificatory powers. It legitimated the invalid’s retreat to the sickroom in years before the rest cure arrived to provide a more overtly medical model of repose and seclusion as proper “treatment” for nervous diseases believed to be caused by overwork. In “Shattered Nerves,” Janet Oppenheim makes the important point that “with varying degrees of efficacy, medical men had been using the separate aspects of the rest cure for some years” before S. Weir Mitchell famously put them together to treat neurasthenia, hysteria, and anorexia. She also notes, however, that it “was never received as gospel in Great Britain” (215). Most interesting in light of the “prehistory” I am associating with Martineau’s text is Oppenheim’s idea that the rest cure as it would develop much later in the century would revolve around “the restoration of invalids to domestic life” (215).8 Given Martineau’s association of the sickroom invalid with moral superiority, it is also interesting that—as Oppenheim points out—many in the medical profession responsible for developing the rest cure believed that their patients should “be surrounded by persons who would have moral control over 8. The patient for whom S. Weir Mitchell first developed the rest cure was described as an “invalid.” For an interesting discussion of contemporary reverberations of the rest cure, see Michael Sharpe and Simon Wessely’s “Putting the Rest Cure to Rest—Again,” British Medical Journal 316 (14 March 1998): 796.

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them” and that therapy centered “on the struggle to dominate the ‘unsound mind’ of the patient” (Oppenheim 213). It also provided Martineau with a convenient point of reference from which to launch her claims for the particular mental abilities and moral superiority of the invalid—as Alison Winter notes, her sickroom was “staged to provide the appropriate context for a particular characterization of the invalid” (“Harriet Martineau” 606). References to the sickroom as a “retreat” and “recess” and to the “leisure” it affords are counterbalanced in Martineau’s text by ideas of suffering as a kind of work and references to interiority as activity in its own right. In her dedication, for instance, she notes how “we are alike willing, having worked while we could, now to suffer as we may, to help our kind in another mode” (xvii). And in discoursing on “becoming inured” she admonishes her fellow sufferers to make “activity of spirit suffice” when “ease of body” is out of the question (149). Such counsel might easily appear glib were it not that Life in the SickRoom devotes an extraordinary amount of space to documenting what such “activity of spirit” might entail. Writing of the “boundless career opened to [her] within the four walls of [her] room,” Martineau repeatedly gestured toward the opportunities for introspective work made available through sickroom confinement (47). Although essentially immobilized within the sickroom, the invalid depicted in the book is, much like the patient persona of Henley’s In Hospital, a model of attentiveness who seems to be ceaselessly looking, thinking, and “speculating.” Martineau herself struck others this way. Although Carlyle once found her “confined to a sofa” and “dangerously ill,” he described her as “for the rest, brisk, alert, invincible as ever” (Webb 196). Martineau argues in her book that the work of observation and introspection was made easier by the vantage point supposedly afforded by the sickroom. “Though I, and my fellows in lot, must wait long for the seraphic powers which would enable us fully to enjoy and use our position, we have the position,” she asserted (77), resorting to a familiar trope. Similarly, she explained the invalid’s supposed capacity for grasping moral distinctions by writing, “They are so to us especially, from the singular advantage of our position for seeing their beauty” (105). Critics of Martineau have long recognized her penchant for “symbolic vantage point[s]” that served her as metaphors “for mastery of knowledge” (Broughton 30), and she clearly used the sickroom in just such a way, equating it throughout her narrative to a domestic “lookout” that afforded the invalid a wide view for observation. Indeed, in one of the mesmeric trances that ostensibly heralded her recovery, Martineau was said to have proclaimed, “You can see further from a prison cell than the top of a mountain” (qtd. in Webb 252).

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Rhetoric of seeing permeates Life in the Sick-Room in a range of ways, enabling Martineau to establish with ease the connections between invalids’ opportunities to observe and their propensity to understand. She makes abundant reference to the act of seeing in its most literal, concrete sense. Sentences like the following abound in the text: “Against the sky I see the stacking of corn and hay in the season, and can detect the slicing away of the provender, with an accurate eye, at the distance of several miles” (63). Describing her attention to flags as an important emotional “resource,” she writes, “When I look abroad on Sabbath Mornings, it tells of rest and church-going; and it is a matter of serious business with me to see it brought down at sunset,—a mute token in which there is more pathos than I could tell” (170). She writes often of the pleasures afforded by her trusty telescope.9 “Sometimes I point my telescope, to see the sailors’ lips move in the utterance of a foreign tongue,” she tells readers in the chapter “Some Perils and Pains of Invalidism” (170). And in “Sympathy to an Invalid” she writes, “If the morning is sunny, I actually see, with my telescope, the gay crowds that throng the opposite shore after church,” noting that “the sight revives the dimmed image of crowded streets, and brings back to [her] ear the almost forgotten sound of ‘the church-going bell’” (53–54). Contemporaries of Martineau’s who wrote about Life in the Sick-Room also picked up on the motifs of seeing and vision that permeate the text. Samuel Smiles, for example, notes the scenery she “viewed from her chamber window” (“Harriet Martineau” 507) and writes how “gazing upon such pictures as these, she heard at a distance of the wonders of Mesmerism” (509). Acts of seeing were not simply opportunities to relieve boredom or indulge in sentimental and nostalgic pleasures; rather, they provided Martineau with what she believed was the basis for philosophical understanding. As Diana Postlethwaite writes, her sickroom “was transformed from a cloistered retreat into a place of visionary perspective” (603). Valerie Sanders makes a similar point when she writes that Martineau “believed that her powers of understanding were strengthened, her insight sharpened, by peace and solitude” (92). Describing invalids as “gazers into the mirror of events” (Life in the Sick-Room 201), Martineau paused midway through her discussion of “Life to the Invalid,” to explain, 9. Noting that “the window was a great resource” to Martineau, R. K. Webb describes the “remarkably varied prospect” of its views of gardens, the mouth of the Tyne river, and South Shields. In the same passage he notes that a Mrs. Reid gave Martineau “a stand telescope through which she could watch the ordinary occurrences at sea and along the river and keep herself in touch with life outside” (194 –95). Diana Postlethwaite notes that “the telescope gave her a broad, detailed, and direct vision of the human world beyond the walls of her sickroom, while metaphorically it also could be trained on her own soul” (602).

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When I think of what I have seen with my own eyes from one back window, in the few years of my illness; of how indescribably clear to me are many truths of life from my observation of the doings of the tenants of a single row of houses; it seems to me scarcely necessary to see more than the smallest sample, in order to analyze life in its entireness. I could fill a volume — and an interesting one, too —with a simple detail of what I have witnessed, as I said, from one back-window. (93)

Depicting herself as a keen and assiduous observer—a role she had perfected in Society in America and How to Observe Morals and Manners, two works written shortly before her Tynemouth years—Martineau appeals to the rhetoric of social science to authorize her philosophical reflections. “Let what I have said go for specimens of our observation of life in two or three particulars,” she tells readers in the same passage (93). With characteristic aplomb, she moves with evident assurance from an account of sights seen “from one back window” to the “truths of life” that such sights reveal to her. Claiming at various points throughout Life in the Sick-Room that invalids “see further” than the healthy, Martineau argues that this very strength proves something of an impediment to relations between the sick and the healthy, as when she warns her fellow invalids to be wary of impatience at others “not seeing as far as we do” (139). As her references to “seeing further” suggest, Martineau believed that invalids had distinctive powers of perception that constituted a unique subjectivity: “We see everything with different eyes,” she proclaims, illustrating the claim by writing, “—the chest of drawers,—the walls,—the bookshelves, and the pattern of the rug. We have been seeing the Northern Lights and icebergs; we have been watching for avalanches, or for the sunrise from Etna, or gazing over the Pampas, or peering through the primeval forest; and fragments of these visions freshen the very daylight to us” (73). As Martineau’s dizzying array of verbs implies, the invalid is equipped with the power to see into and beyond everyday objects and to envision and take pleasure in more imaginary acts of seeing.10 In part, she believed that these powers of perception accrued from invalids’ many opportunities for 10. The rhetoric of seeing would serve Martineau equally when she turned to mesmerism for her cure. Valerie Sanders includes the following letter that Martineau wrote to Monckton Milnes in 1845 when she began her stint with mesmerism: “‘For one instance, I saw the march of the whole human race, past, present & to come, through existence, & their finding the source of Life. Another time, I saw all the Idolatries of the earth coming up to worship at the ascending series of Life-fountains, while I discovered these to be all connected,—each flowing down unseen to fill the next,—so that all the worshippers were seen by me to be very easily adoring the Source’” (Harriet Martineau, 108)). Emphasis in original.

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uninterrupted observation. “I have learned by observation where and when to look for the rising moon; what a superb pleasure it is to lie watching the sea-line, night after night, unwilling to shut the window,” she writes in “Nature to the Invalid” (69). More often, Martineau implies that the invalid’s superior moral understanding was secured by detachment and distance from the everyday working world. In the chapter “Temper,” she explains: “By our being withdrawn from the disturbing bustles of life in the world; by our leisure for reading and contemplation of various sides of questions, and by our singular opportunities for quiet reflection, we must, almost necessarily, see further than we used to do, and further than many others do on subjects of interest, which involve general principles” (138). Claiming at another point that invalids “see everybody that is busy doing what we did—overrating the immediate object” (82), Martineau argues that the invalid “sees through” the false promises of a demanding market society, and thus understands what the healthy working world cannot see and cannot understand. “To us, whose whole life is sequestered,—who see nothing of the events of which we hear so much, or see them only as a gleam or shadow passing along our prison-walls, there is something indescribably affecting in the act of regarding History, Life, and Speculation as one,” she writes in one of her more overwrought moments. The chapter “Life to the Invalid” is chock-full of sentences that begin with the phrase “we see” and end with statements of judgment, moral understanding, or even prophecy. “We see the progress of amelioration, silent but sure,” she writes in one of these many prophesying moments (88). And she goes on to explain, “Nothing can be more ordinary than the modes of life which I overlook, yet am I kept wide awake in my watch by ever new instances of the fulness of pleasure derivable from the scantiest sources; of the vividness of emotion excitable by the most trifling incidents; of the wonderful power pride has of pampering itself upon the most meagre food; and, above all, of the infinite ingenuity of human love” (94). Steeped as it is in a discourse of observation and insight, Martineau’s narrative is richly suggestive of how nineteenth-century invalids could transform the domestic sickroom into a unique medical space, one that enabled them to conduct (rather than be subject to) a kind of surveillance that in turn seemed to equip them with a uniquely potent subjectivity. The sickroom occupant, in other words, was in control of the very “gaze” that some theorists believe divests the clinical patient of individuality and sense of self. Julia Epstein summarizes this line of thought well when in Altered Conditions she writes, “Patients come to the clinic for a specialized kind of surveillance. As Michel Foucault would have it, he is subject of a medical gaze that alien-

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ates the body from the subjective person, that creates, in other words, the ‘patient’ as a special type of person” (28).11 So confident was Martineau of the power of the invalid’s gaze that she wrote, “By means of that inimitable telescope we carry about in us, (which acts as well in the pitch-dark night as at noon, and defies distance and house-walls,) I see in turn a Christmas tree, with its tapers glittering in a room full of young eyes . . . and I hear, not the actual jokes, but the laughter, and ‘the sough of words without the sense,’ and can catch at least the soul of the merriment” (54). Martineau both appropriates the telescope as a metaphor for the invalid’s ability to “see further” and renders a domestic scene that adds sentimental appeal to her characterization of the invalid. At the same time, she stresses the figure’s ability to “defy” via observational powers the home’s structure of separation and confinement. In most respects the invalid Martineau constructs is one whose identity as invalid subsumes other components of identity—we get precious little overt reference to her status and experiences as a woman, as a member of the middle classes, as a person with a particular religious faith, or as an inhabitant of a particular region in Britain. Still, her emphasis on the power of the invalid’s vision to defy boundaries resonates with meaning. Describing the stereotypical Victorian domestic woman, Diane Price Herndl has written that “whereas women in general are characterized as weak and lacking power, better off staying quiet at home, the invalid is specifically recognized as even weaker and more powerless than most women and is required to stay at home” (2).12 Yet in the rhetoric designed to stress the invalid’s visionary power, Life in the Sick-Room undercuts the association of invalidism, particularly female invalidism, with weakness of will or powerlessness. Much as in her autobiography, which stresses her self-determination in seeking out the sickroom, Martineau constructs a figure made active through mental exercise. Invalidism, in Martineau’s estimation, exercises and develops the sufferer’s agency. In Martineau’s view invalids “lie on the verge of life and watch, with 11. Trev Broughton applies a compelling version of the idea of the gaze to Martineau when she argues that the “view from the sickroom” frames Martineau’s autobiography: “From a moribund position she is able to reverse the cultural gaze that defines the female body, and preferably the dead female body, as the object par excellence of scientific enquiry and aesthetic desire, and can explore from within the ambiguities inherent in the lexicon of ideal femininity: in duty, self-sacrifice and martyrdom . . . but also in the language of religiosity, innocence, deference, dependence and—most riskily for Martineau’s positivism—of nature itself ” (30 –31). 12. Herndl goes on in her introduction to develop the more nuanced point that women adopted a range of strategies of “defining or using invalidism,” some that subverted norms and others that colluded with them.

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nothing to do but to think, and learn from what [they] behold,” and not unlike Ellen Chadwick, she uses Life in the Sick-Room as a repository for the lessons learned by watching and beholding (77). The trope provides her with a mechanism for directing her readers to adopt a similar stance, as when in “Nature to the Invalid” she commands presumably healthy readers to consider the “long-suffering sick” as follows: “Watch the effect upon them of a picture,” and “Observe the sad fondness with which they cherish flowers” (71). Whereas most of Chadwick’s “lessons learned” were about God’s will, Martineau’s are focused on the psychological experience of chronic illness. At several key points in the text, she theorizes about the nature of sensations and of pain. “Sensations are unimaginable to those who are most familiar with them,” she writes in her chapter “The Transient and the Permanent in the Sick-Room.” “Their concomitants may be remembered, and so vividly conceived of, as to excite emotions at a future time: the sensations themselves cannot be conceived of when absent” (27). The theme resurfaces in slightly different form in “Becoming Inured” when she writes, “The truth is, a familiar pain becomes more and more dreaded, instead of becoming lightly esteemed in proportion to its familiarity” (146). Of all the “truths” that Martineau desired to impart, none is more frequently invoked in her narrative than that of the “class un-consciousness” of the chronically ill. Here we find an explicit example of the invalid author’s linking invalidism with the power to subsume other dimensions of a person’s identity. “The proud” and the “humble” are alike prone, in Martineau’s estimation, to the debilitating consequences of “subjection to a besetting thought,” she writes in “Power of Ideas in the Sick-Room” (160). In “Death to the Invalid” she explains: “In our retirement, we are apt to forget, till expressly reminded, the importance of distinctions of rank and property in society, so nearly as they vanish in our survey of life, in comparison with moral differences” (118). “Wealth would be a trouble to us,” she proclaims in “Some Gains and Sweets of Invalidism,” and “ambition and its objects” little more than “voluntarily incurred bondage and fatigue” (187). Such declarations are of a piece with claims in the text for the inherent separation of sickroom existence from the social and economic pressures of public life. Yet Martineau sometimes seems to protest too much; her frequent recourse to a contention that invalids have a special affinity for and access to truth has a similar effect. “Avoid every shadow of falsehood,” she advises all visitors to the sickroom, as if any hint of such would further imperil the well-being of the invalid ensconced at its center. “Everything but truth becomes loathed in a sick-room,” she writes in “Sympathy to the Invalid” (45). Martineau’s emphasis here compares in interesting ways to her argument in “Letter to the

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Deaf ” that the partially deaf were “often unscrupulous about truth” and “seduce[d] into falsehood” by their conviction that others were “taking advantage of [them] in what they say” (53–54). Invalids are uniquely subject to “a scrupulosity, particularly about truth, which brings endless troubles,” she contends in “Some Peril and Pains of Invalidism” (173). “From a crowd of falsehoods, what a revelation we have of the truth, which no one man, nor party of men, could reveal!” she exclaims in “Life to the Invalid” (79). Martineau clearly believed herself to be speaking the truth when she made these assertions, but she might not have felt compelled to argue with such intensity for the invalid’s honesty had she not been simultaneously anxious about the association of the figure with specters of the idle, the malingering, the hypochondriac, and the fraudulent—in short, with the possibility that for many the figure of the invalid was also that of the impostor.13 And given her physician brother-in-law’s skepticism about whether she was as hopelessly ill as she herself believed, it is likely that these concerns took root for largely personal reasons. Webb explains that “her brother-in-law knew perfectly well that there was no malignity; he always believed that in time she would ‘take up her bed and walk’” (198). In his Medical Report of the Case of Miss H —— M——, Greenhow wrote, “She never willingly listened to my suggestions of the probability of such prospective events, and seemed always best satisfied with anything approaching to an admission that she must ever remain a secluded invalid” (22). Greenhow was not alone in openly expressing doubts about the legitimacy of Martineau’s claims of ill health. Trev Broughton quotes Martineau’s “estranged friend” Elizabeth Sedgwick as saying that Harriet “could not get ill—or get well—without some special fussification” (31). Martineau’s anxiety about the invalid’s identity as an embodiment of and spokesperson for truth certainly took hold because of the cloud of doubt that surrounded her; the anxiety she experienced comes to the fore most vividly in her representations of the sickroom as a site of self-scrutiny. At one point in her text she imagines how various invalids would appear to “an observer of the human mind” with the ability “to pass from retreat to retreat” (103), and throughout her narrative she invokes an astonishing array of “self ” words to represent the mind that such an observer might encounter if invalids did not carefully monitor their feelings. Exposing her 13. There are other ways to interpret Martineau’s many references to truth. In attempting to establish that Martineau’s religious beliefs changed while she was in the sickroom, Vera Wheatley writes, “During the years 1839–1844, when she was lying on her sofa in those Tynemouth rooms, she had ample time to meditate on the truth or lack of truth in what she had hitherto accepted as her religion” (233).

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sense of the self ’s corrosive potential, her vocabulary reveals her understanding of invalidism’s potential to put identity itself on trial: concepts such as self-importance, self-deception, self-congratulation, self-weariness, self-abasement, self-disgust, self-distrust, self-disquiet, self-exposure, and self-contempt abound in Life in the Sick-Room. She warns in the chapter “Temper” of the various threats to “self-respect,” without which “there can be none of that healthy freedom of spirit which animates others to freedom (131). Martineau also attends in Life in the Sick-Room to the invalid’s valuable opportunities for self-communion and their potential for such noteworthy attributes as self-mastery, self-command, and self-reliance. The cumulative effect of her litany is to undermine the ideal of self-sacrifice and effacement so crucial to the representational strategies of women’s autobiographical writing in the Victorian era.14 Nevertheless, the sheer proliferation of words linking concepts such as deception, abasement, distrust, and contempt to the idea of “self ” overwhelms the narrative’s attempt to represent more positive possibilities for the sufferer’s identity, in the end suggesting that however wise and prophetic, the invalid’s “self ” was acutely susceptible to weakening, corrosive forces. Valerie Pichanick astutely observes that while Martineau “wrote of aspiring to attain ‘a trusting carelessness as to what becomes of our dear selves,’” the “very act of writing Life in the Sick-Room was a denial of that ‘carelessness’” (128). The sheer density of “self ” words in Martineau’s narrative seems to bear out this interpretation, but their impact is neutralized at critical points in the narrative that move the discussion from the subjectivity of the invalid to the ontology of invalidism. In “Sympathy to the Invalid,” for example, she explains that what consoles and animates her is the wisdom of the saying that “it is what we are that matters—not what we do” (47). She repeats the formula at several points, as when in “Power of Ideas in the Sick-Room” she writes that to her the most “powerful” single idea is “that it matters infinitely less what we do than what we are ” (155). The notion is particularly interesting in light of the narrative’s use of a discourse of insight and observation, for while what is done can be seen, witnessed, and verified, what is can only be intuitively understood. If Carlyle was too harsh in his criticism of Life in the Sick-Room —scorning Martineau by suggesting that she required her readers to “look” and 14. See Broughton’s “Making the Most of Martyrdom: Harriet Martineau, Autobiography and Death” for an extensive and helpful development of this argument. Broughton argues that “by teasing out the complexities of feminine self-sacrifice as pleasurable pain, as self-promotion through self-denial, she comes close to expressing and exposing the riddle of femininity in psychoanalytic terms” (36).

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“see” her suffering—he could not have chosen more apt language to capture the exhibitionist anxieties provoked by the figure of the invalid as sickroom occupant, anxieties exacerbated by a book that seemed to render its readers voyeurs. No one was more aware of such anxieties than Martineau. She may have told herself (and others) that she suffered “for other people’s information,” but the fact was that she had only experience of her own pain to describe. However difficult it is to assess the usefulness of Life in the SickRoom, it is clear that other invalid authors found it compelling. Passages from Life in the Sick-Room were routinely appropriated by Christian invalids and reproduced in their commonplace books. These passages typically appear without attribution, perhaps in deference to Martineau’s vaunted desire for privacy and perhaps indicating that her status as the author of Life in the Sick-Room was not as immediately apparent as some thought. The American edition of Life in the Sick-Room, published in 1844 by Leonard C. Bowles and William Crosby of Boston, almost certainly inspired narratives written by invalids in the United States. Its influence is evident in Letters from a Sick Room, published just one year later, a text that, while far more overtly Christian in emphasis, treats topics such as “sympathy” and “comforts” much as Martineau did and, as significantly, exploits the tropes of household and societal hurry to stage its claims for the sanctity of the invalid’s sphere. And much as Martineau evidently intended, Life in the Sick-Room reached an audience of the healthy as well. Calling the book “a popular triumph,” Alison Winter observes that “through it a large proportion of the reading public came to feel that the life in the sickroom was not to be the scene of subjection and management of the ill, but the seat of unworldly authority” (“Harriet Martineau” 607).15 “Popular triumph” or not, Life in the Sick-Room may well have lost something of its impact when Martineau, believing herself cured by mesmerism, turned her attention to that subject, both personally and professionally. With words carefully chosen to be neutral, Samuel Smiles wrote of Martineau’s “cure,” “Having tried every imaginable remedy, she determined to try this; and whether from the potency of the remedy or the force of the patient’s imagination, certain it was that she was shortly after restored to health” (“Harriet Martineau” 509). That she would discover through mesmerism (her route to recovery and release from the sickroom) evidence of the mind’s control over the body that seemed to corroborate many of her claims for chronic invalidism is testimony both to her self-confidence —her 15. Assessing the print-run figures for Life in the Sick-Room, Alison Winter adds the important caveat that its popularity was more of an “impression” than a fact. See “Harriet Martineau,” 604n32.

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investment in what Life in the Sick-Room called “the power of ideas”—and to her grasp of the expedient. As Alison Winter writes, “Martineau availed herself of a variety of conventions of self-representation which were tactically useful to her in different situations, but which sometimes conflicted with one another” (“Harriet Martineau” 614). The sensation stirred by her Letters on Mesmerism, which were first published in installments in the widely read weekly review the Athenaeum, propelled Martineau back to a more active, public life; but the five long years she spent cultivating the identity of the invalid as one endowed with unique observational and introspective powers enabled her to rejoin that world with renewed confidence in what she brought to it. Life in the Sick-Room has been overshadowed in scholarship on Martineau by Letters on Mesmerism, which clearly garnered more public recognition and coverage in the press, but the earlier work still stands as a defining moment for a genre of invalid literature. Never again would a nineteenthcentury British author deem it necessary or desirable to analyze chronic illness in so extended a manner. Yet if Harriet Martineau managed to establish the sickroom as a seat of authority and to fashion for herself an identity as authority on life there, she did not have the final say. Just as the invalid continued to occupy a place in Victorian culture, so too did interest in the invalid’s habits and mind-set continue to generate print. To turn from Life in the Sick-Room to the shorter, journalistic contributions of George WhyteMelville, Wilkie Collins, A. B. Ward, and Alexander Shand that appeared later in the century is to witness intriguing resurfacings of Martineau’s themes rendered with an irony and an air of detachment reminiscent of Charles Lamb. Far from effacing their identities as men, for these authors, as for Lamb, invalidism inevitably entailed coming to terms with masculinity. If the anonymous author of “Bachelor Invalids and Male Nurses” spurned the tendency of women “to make a business of an illness” (318), male invalids found the rhetoric of business uniquely applicable to their experiences of the sickroom. “Supine and Easy ”: The Life of Bedridden Businessmen The title of George Whyte-Melville’s 1864 Fraser’s Magazine essay (“A Week in Bed”) points at once to a crucial dimension of his representation of the invalid, for notwithstanding his claim that “by the time you have been a week in bed your habits have become those of a man who is crippled for life” (335), he clearly envisioned a very different kind of person than Martineau’s “prisoner” of “long and irremediable sickness” (Life in the Sick-Room 33).

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The difference was not simply in the duration of illness. Martineau’s beliefs encouraged her to construct an invalid whose identity as a sufferer subsumed gender, but for Whyte-Melville middle-class masculine identity was the dominant frame through which invalidism was experienced.16 This attitude becomes apparent in the opening line of “A Week in Bed”: “No great affliction, perhaps; no great tax upon a man’s heroism, or his fortitude: but a grievance nevertheless, an undoubted grievance, whether we look forward to it or look back to it, or contemplate the eighty-four hours of enforced idleness, on either side from noon of the intermediate day” (327). By the time he wrote “A Week in Bed,” Whyte-Melville had through his novels and poetry cultivated an identity as a “man’s man,” one devoted to fox hunting and, through his financial successes and gentlemanly status, able to indulge interests in military, sporting, and fashionable life more generally. Thus, that the invalid persona of “A Week in Bed” does little more while bedridden than contemplate his manliness is not entirely surprising. At one point he mockingly refers to “a cynical friend of ours, not a bachelor, [who] says that women make good nurses, because they take a pleasure in the contemplation and infliction of pain” (328). He wistfully watches his wife in her efforts on his behalf, reminiscing about “the days when a fair young girl sat with [him] under the limes at noon” (328). He spends time “reading of bold, venturous deeds” (331). And he regretfully ponders the times when he spoke “harsh words” to his wife because his “dinner was late or [his] boots badly blacked” (331). Through the wistful, regretful tone of his remarks, an irony similar to that of Lamb’s convalescent comes through. Although claiming to recognize what is wrong about men, he is clearly taking advantage of his illness to display a particular type of manly attitude, as when he exclaims, “Dear, dear! if women would only be as good to us when we are well as they are in our sick rooms, if they could but share our high spirits as genially as they coax and comfort our low, what a world it would be for Jack and for Gill too!” (332). Whyte-Melville’s invalid is not an everyman; like Lamb’s convalescent, his is an every middle-class man, a person he describes as “supplied with the necessaries, and, indeed, the luxuries of life, one to whom the loss of a week is an inconvenience rather than a misfortune” (327). Following up on this generic description, he explains his subject as follows: “You have a business of some sort which must not be neglected, but which can yet bear well enough the short absence of its head without derangement to its professional routine” (328). Having established his invalid as a businessman, 16. See Linda Peterson’s “Harriet Martineau: Masculine Discourse, Female Sage,” 176.

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Whyte-Melville deploys the familiar rhetoric of wear and tear to launch his moral message: “Immersed in continual occupation, as in this age of competition every man of business must necessarily be, and too much accustomed to treat daily the same circular round of thought, such a change of ideas as is produced by a day’s leisure cannot but be beneficial” (331). And, as if to cement the argument, he intersperses throughout his essay reminders of the hurry and worry that accompanied his life of “continual occupation.” “Everybody knows the value of those ‘forty winks,’ generally purchased at the price of an uncomfortable toilet, a hurried breakfast, and a haunting sense of being too late for everything all day,” he writes at one point (328). He contemplates how good it is to take breakfast “slowly” while enjoying his paper, noting how “the subtle arguments of a leading article are necessarily thrown away when absorbed alternately with hurried gulps of hot tea and wedges of half-masticated muffin” (329). Thus, when throughout his essay Whyte-Melville calls overt attention to his “prostrate form,” it is understood that his recumbent position is emblematic of a health crisis emanating out of, if not directly caused by, his identity as a “man of business.” No motif recurs more often in “A Week in Bed” than that of the invalid lying down. “In a few minutes you are supine and comfortable again,” he writes of the doctor’s arrival, repeating the reference later when he describes settling down, “supine and easy,” with a good book (330, 331). “Again the pair of traitors glance responsively across your prostrate form,” he writes of the doctor’s consultation with his wife (330). “Lying on your back helpless, [you] are led reflectively to a new-found appreciation for the blessings of good health” (331). Whyte-Melville’s emphasis in these and other passages stands in marked contrast to Martineau’s image of the invalid as seraph who, “poised on balanced wings,” presumably observes humanity while comfortably ensconced at a distance above the fray (77). Although not without its pleasures, the supine position that he constructs is not particularly empowering, and the invalid persona of “A Week in Bed” consequently enjoys little of the observational powers and prophetic vision available to Martineau and the community of invalids rhetorically constructed in her narrative. His comment that “your ear, a little nervously sharpened, detects a smothered titter and a childish scuffling of feet high up on the next floor” (329), while in some sense capturing the heightened sensory powers of the invalid, at the same time conveys this sufferer’s comfortably diminished perspective. And from out of the superficially more mundane position of the “supine and easy,” Whyte-Melville’s invalid persona renders moral messages considerably less lofty than those of Martineau’s. He writes, “Mean well, therefore, as strenuously as you please while on your

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back. You are neither a devil nor a monk—far from it; and never doubt but that, when on your legs again, you will strive to the utmost to fulfill the engagements entered into by the bedridden penitent with yourself ” (335). The half-hearted tone of his comment conveys well the spirit of the essay as a whole, which is neither wholly mocking nor fully earnest. As its title implies, “A Week in Bed” ends when the invalid is recovered enough to begin contemplating a return to activity, for, as the author dryly observes, “With your convalescence we have nothing to do” (335). WhyteMelville seems most interested in representing the psychological adjustment the invalid must make to the transition back to work: “Can it be only seven days since you were up and doing?—only a week ago that you were one of the business atoms in the swarm of the busy street? (335). His language evocatively recalls the quotation Lamb used to render the invalid’s fall from grace, “What a speck he is dwindled into!” and the figure’s corollary return to a life of journalistic insignificance. And yet Whyte-Melville’s invalid is noticeably less preoccupied with the impact on his ego of the transition from life in the sickroom to life in the working world. When he remarks, “Already your pleasure in release from confinement is somewhat damped by anticipations of extra work, accumulated letters, much to be put right that has unavoidably gone wrong from such a stoppage in the main stream of business as the absence of its head” (335), it is clear that his work ethic supersedes more egotistical reflection. Ultimately rendering his experience of invalidism through economic metaphors—he writes of affliction as “no great tax upon a man’s heroism” and moralizes about “compensation” as “the fundamental principle that keeps humanity in equipoise” (327, 332)— he returns to his life essentially unchanged. Wilkie Collins, too, sought to emphasize the temporary nature of his experience with confinement in “Laid Up in Lodgings,” which he originally published in Household Words in 1856, and like Whyte-Melville, he makes his readers instantly aware of the significance that assumptions about his masculine identity have guided his interpretation of his experience with illness: “I am a single man,” he writes in the essay’s opening paragraph, “but as I have already intimated, I never knew what it was to enjoy the desolate liberty of the bachelor until I became an invalid” (200) (fig. 24). The references to his status as bachelor compete with other overt presentations of persona in the essay, such as the following: “I present myself at once in the character of a convalescent visiting Paris” (199) and “Let me now be permitted to reappear as an invalid laid up, for the time being, in a London cab” (214). In these and many other statements, Collins calls attention both to the performative nature of the sick role and to the recognizability of the

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Figure 24. “The Convalescent.” This illustration done to accompany Wilkie Collins’s “Laid Up in Lodgings” (1856) depicts the convalescent conversing with his landlady, Mrs. Glutch. Nearby are his trusty “physic-bottles” as well as medical manuals and newspapers.

figure of the convalescent or invalid to the popular, middle-class readership of Household Words. Much like his predecessors, Collins concerns himself both to represent the “little domestic world” of the invalid and to convey the distinctive features of the invalid’s state of mind: “I looked at the world about me purely from the sick man’s view” (200). Unlike Martineau and others who sought to attribute unique advantages to this perspective, Collins describes it as “mental weakness” and anxiously disclaims any connection to “excessive selfishness or vanity” (200). His desire to write about his experiences in the sickroom represents, he concludes, “the involuntary egotism of a sick man” (201). For Collins, what disturbs is the power of illness to make bodily concerns uppermost in the invalid’s mind: “Pain to suffer; the swallowing of drugs and taking of nourishment at regulated periods; daily restraints that I must undergo, and hourly precautions that I am forced to practice, all contribute to keep my mind bound down to the level of my body” (201). If Collins draws decidedly different conclusions than Martineau does about the reach of the invalid’s perspective, he shares with her a preoccupa-

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tion with seeing; and much like Life in the Sick-Room, “Laid Up in Lodgings” attends in detail to what the author can see from his bedroom window. Collins’s strategy is to stress at every opportunity the idea of limitation. He reminds his readers that his experience with “the great Parisian world outside” is “bounded by the prospect” from his window (210); he confesses that he looks “with lazy eyes” (210); he comments that “the sights I watch with interest are those only which seem to refer in some degree to my own invalid position” (210); he describes his view as “curiously circumscribed” (211) and later concludes that “my fatal invalid prepossessions blinded me” (215). Although his primary purpose seems to be to expose how illness and confinement combine to diminish the invalid’s interest in the world around him, he implies as well that his masculinity has been compromised: “The only objects which I now notice attentively from my window, are, oddly enough, chiefly those which I should have missed altogether, or looked at with indifference, if I had occupied my bachelor apartment in the enviable character of a healthy man” (211). Having sardonically established himself as having been emasculated by his stint with illness, Collins moves on in his essay to detail the domestic world of the invalid. This entails descriptions not only of the rooms he occupies and various accoutrements of the invalid that line the shelves, but also of the people who inhabit his world—nursemaids, landladies, and maids-of-all-work. In these short “studies of character” (229), Collins depicts himself as simultaneously at the mercy of a series of (female) caretakers who little understand his physical condition and disposition and yet oddly in control by virtue of being able to apprehend their faults and share them with his readers. “Mrs. Glutch is resolved to make a conquest of me,” he writes at one point (217), but shortly afterward he tells his readers, “it is part of my character, as a sick man, that I know by instinct when people really pity me, just as children and dogs know when people really like them; and I have consequently, not been five minutes in Mrs. Glutch’s society before I know that her sympathy for me is entirely of that sort, of which (in the commercial phrase) a large assortment is always on hand” (218). Although Collins’s humor here clearly distinguishes him from Martineau, his claims for the invalid’s instinctive ability to penetrate to the supposed truth of feelings toward him is not all that different from what Martineau had argued in Life in the Sick-Room. He structures the rest of his narrative around “studies of character” but, like Martineau, resists rewarding readers with the promise of recovery. If he has twice been “laid up in lodgings,” he nevertheless does not vacate them with health. “I have got the doctor’s leave to move into the country, and have terminated my experience

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of London lodgings, by making my escape with all convenient speed from the perpetual presence and persecutions of Mrs. Glutch,” he writes at the end of his essay (229). Although written some thirty years later and published in the American magazine Scribner’s, A. B. Ward’s essay of 1889, “The Invalid’s World,” follows a pattern quite similar to that of “A Week in Bed” and “Laid Up in Lodgings.” Ward was known to readers for his essay “Hospital Life,” published a year earlier, which had rendered with ethnographic detail much about the patient’s perceptions of everything from temperature charts to hospital architecture, the activities of the resident physicians, and the routine of visitors’ day. Claiming that “hospital scenes are to those of ordinary life what Doré’s pictures are to those of other artists. Glimmer and gloom come close together and emphasize each other” (712), he begins at the point when the patient is picked up by an ambulance and ends with “the discharge!” where “something very like a regret seizes you” (715). What is most significant about “Hospital Life” is that from start to finish it is directed specifically to a hypothetical invalid reader. Ward posits first that “the man of business stops thinking stocks and real estate long enough to think ‘poor devil’” when seeing the ambulance pick up the hospital’s patient, and then asks, “What does the Invalid? He has heard the warning bell of the ambulance, and he watches, from behind his curtains, in a neighboring avenue, the curious swarm that gather and part, and gather again, like flies” (697). Soon after this point, he again invokes the image of the invalid observer, hovering from behind his cover: “You, my Invalid behind the curtains, are neither Dives nor Lazarus. You cannot summon the kings of Pathology to listen to your groans; neither does it depend upon the charities of your fellow-men if anyone shall hearken to them” (697). Much like Scrooge’s ghostly tour guides, Ward subsequently embarks on a hypothetical journey with this invalid, taking him to various hospitals in the city, pointing out the distinctive features of each, and encouraging him at each juncture to empathize with various sites of suffering: “You try to sleep, but feel more like coughing with the consumptive, and groaning with the old fellow across the aisle who is having a fresh poultice put on his lame leg,” he writes at one point (705). “Still in the carriage, my Invalid?” he writes at another point (702). What becomes increasingly clear as the essay progresses is that the narrator-host sees himself as a kind of moral educator and believes that the invalid is especially in need of the kind of education offered through his tour. These assumptions surface vividly when he writes, “The return of an etherized patient is more trying, but it rarely hurts the invalid

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looker-on. It rather makes a man of him. Here is something real in exchange for his fancied terrors” (711). The invalid Ward represents, much like that constructed by Lamb and Collins, is implicitly feminized and in need of rational, masculine understanding, which presumably will counter his hypochondriac tendencies. “So contradictory are the fancied and the actual in the invalid’s life,” the narrator reflects at one point (707). The essay ends when, tour over, the narrator assures himself that his invalid tourist has seen enough to “dismiss” from his mind an image of hospital life as “repulsive” and replace it with one at once truer and more charitable. He is thus more prepared to reintegrate himself into the competitive market: “As for you, my invalid, you have lost your burden of pains and have gained the power to take your place in this give-and-take world, where whoever cannot pay for his lodging runs the risk of getting kicked out in the cold” (715). His is a vision quite different from the “wonderful world” that Henley encounters in the lyric “Discharged” that appears at the end of In Hospital (42). The cloistered and curtained sickroom has provided temporary security and an unparalleled opportunity for contemplation of the invalid’s habits of mind, but the male invalid is clearly destined to return to a life of activity characterized by its competitive edge. Many of the same themes resurface in “The Invalid’s World,” which begins by paying effusive tribute to the doctor, depicted as “the mastermechanic” and “autocrat” of the invalid’s world (57). Indeed, Ward reveals so little about the invalid at the center of the “world” he depicts that readers must deduce his identity from the narrator’s remarks about doctors, nurses, and visitors. Writing that his doctor “reconciles me to myself by a quieting powder,” he reveals his nervous predisposition, an uneasiness about his experience with illness that undercuts the ease and familiarity implied by his reference to “we old chronics” (61). Yet his invalid has numerous sources of strength. Much like the narrator of Collins’s essay, he summons up for his readers a series of images of encounters with caretakers. And Martineaulike, he speaks with a moral authority derived from long experience with sickroom etiquette and culture: “To withhold sympathy and to neglect to ask for it are equal social sins” (73). He anxiously demonstrates through his representation of his relationship with physicians that his status as an invalid has not compromised his masculinity. “I would rather have R. to lead me to a charge in the battle for health than anyone I know,” he observes shortly before “confessing” to his “mature, masculine preference for sound, smacking doses” (61).

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As the essay proceeds, Ward moves from observations about his own experiences and routine to far more generalized claims about the culture of the invalid. His discussion of the patient’s relationship with doctors, nurses, and visitors prompts him to delve more deeply into the invalid’s mind, and these particular remarks, interspersed throughout his essay, expose the troubled feelings and beliefs lurking just beneath the confident, easygoing demeanor he otherwise projects. Writing of the importance of visitors, for example, he argues that “there is a horrible resemblance between the inhabitants of a beleaguered city and the thoughts and feelings of a man who has been shut up to feed upon himself for days and weeks and months of unavoidable imprisonment. Let the new-comer send a fresh breeze blowing through the fever-filled apartment! Let him bring a feast and the appetite for it! Let him raise the cruel siege!” (69). “In weakness, more than in strength, the change must come from without,” Ward concludes (69). In fact, Ward finds in “the invalid’s world” evidence with which to assess the validity of Darwinian science. “The Survival of the Fittest means more than length of day,” he notes: “It involves the mastery of the feeble by the forceful while life endures, the absorbing of little personalities by great ones, the supremacy of strength in love and in war. A poor lookout for sick folk were there not an obverse side —the parasitical dependence of weakness upon might” (64). However exaggerated, Ward’s analogies help him to represent the darkest sides of the invalid’s interiority, most often construed as the sense of self as captive. But he adds to this notion the idea that, as a consequence of captivity, the invalid is forced “to feed upon himself.” “The instinct of selfpreservation—one may as well call it by a high-sounding name —makes a perfect vampire of a sick man,” he writes, and then observes that “it is not altogether watching, or care, or constant service, or the keen sense of responsibility which exhausts a nurse, nor all of them combined. It is the presence of the patient’s famished body, taking in at every pore the nervous energy of whoever is near” (65). The image is reminiscent of Alexander Shand’s reference in “The Pleasures of Sickness” to invalids as “victims, who were deep in each other’s innermost secrets” (550), and it powerfully suggests a deep unease that Ward associates with certain dimensions of the invalid’s interiority. Even more disturbing to Ward than the image of the invalid consuming the energy of his caretakers is the idea of the invalid alone. Left to his own devices, the invalid he imagines would cannibalistically devour only “self.” In this respect he echoes Collins, who had written, “My own sensations, as a sick man, now fill up the weary blank of my daily existence

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when I am alone, and form the main topic of inquiry and conversation when my doctor and my friends enliven my solitude” (200). These invalid authors evoke the threatening and unhealthy potential of subjectivity itself. Likening the invalid to a consumer of sorts, Ward simultaneously aligns his representation of the sick person’s subjectivity with a critique of nineteenth-century domestic ideology. Although the domestic ideal rendered the home a haven from the working world, its very separation—signified in his essay by the claustrophobic sickroom—ensures its fundamental unhealthiness. In depicting, however briefly, the threatening potential of the invalid’s mind, Whyte-Melville, Collins, and Ward reveal presuppositions about the value and impact of the sickroom experience markedly similar to those developed in different ways by Charles Lamb and Harriet Martineau. Their more overt emphasis on the impact of illness on a robust male persona makes their ultimate inquiry into the figure’s experience of interiority all the more interesting. Seen in light of Talcott Parsons’s understanding of the sick role as a mechanism of social response and control, there is less irony in the fact that a literature seemingly committed to representing invalidism within its most literal context, the sickroom, in actuality used it to probe depths of psychological distance. Deliberately defining the role through the invalid’s separation from market society and the world of work, with their corollary competitive pressures, they ultimately expose the reach of those forces into the home and suggest that they are ultimately inescapable. For all their attention to documenting life in the sickroom, the decided turn to the invalid’s habits of mind reveals ambivalence about contemporary life. Nevertheless, the invalid emerges from each of these texts triumphant, because whether “inured” to a life of permanent pain or instead moving through convalescence toward recovery and eventual reacclimation into the market society, each has come to understand invalidism in terms of the position it requires the invalid to assume and the agency it thereby enables. That Martineau construed that position through the metaphor of the seraph and Whyte-Melville through the motif of the supine may be testimony to the power of gendered identity to determine what kind of symbolic position the invalid needed to adopt in order for illness to be understood as transformative. In their very different ways, the narratives examined in this chapter not only shift the focus from the physical conditions of invalidism to the psychological interest of the invalid, they use that psychological study to elaborate an ontological approach to invalidism—to understand invalidism as more than simply a social role or medical condition. Although

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seemingly unaware of its similarities to these nineteenth-century precursors, in her essay “On Being Ill,” which was not published until 1920, Virginia Woolf provides the perfect coda to earlier studies of life in the sickroom: “It is only the recumbent who know what, after all, Nature is at no pains to conceal—that she in the end will conquer; heat will leave the world; stiff with frost we shall cease to drag ourselves about the fields; ice will lie thick upon factory and engine; the sun will go out” (198).

AF TERWORD

CENTERS, MARGINS, AND VANISHING POINTS Locating Invalidism in the Nineteenth Century

Inertia holds the sick man like a clod to his place. Monotony flaunts before him her grinding repetitions. —A. B. Ward, “The Invalid’s World” Neither good enough for heaven, nor bad enough for the other place, we oscillate in the temperate inertia of folly, answering no end whatever either of God or Devil; surely, one would think, we should be put out.” —Froude, Letter 8 of The Nemesis of Faith

I began this book by declaring my desire to retrieve the invalid from the margins of medical and social history, and I conclude by reconsidering the interpretive implications of this gesture. If the invalid occupied a prominent position in nineteenth-century medical understanding and social life, does it necessarily follow that this figure —capacious enough to contain so many extremes, slippery enough to defy precise definition—should assume a similarly privileged position in a literary and cultural analysis of the period? Elizabeth Gaskell—the Victorian novelist who perhaps made most frequent use of the invalid in her writing—can help me begin to answer this question. I turn to a fiction writer here in part to affirm my emphasis throughout this book on the invalid as a preeminent figure of the nineteenth-century medical, social, and literary landscape. Gaskell makes use of the invalid in all of her major novels—in Mary Barton, Ruth, North and South, Sylvia’s Lovers, Wives and Daughters, and Cranford. The most useful evidence with which to summarize my argument about the invalid’s position, function, and symbolic significance in nineteenth-century Britain is to be found, however, at the margins of her canon. In 1859 Gaskell and her publisher, 245

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Sampson Low, collected a group of previously published works—the short novel My Lady Ludlow, several short stories (many of them originally published in Dickens’s popular magazine Household Words), and a short work of nonfiction titled “The Accursed Race”—into a single volume, which they named Round the Sofa.1 In a range of ways that I will briefly explore, Round the Sofa represents and grapples with the cultural contradictions of invalidism that have most occupied my attention in this book. That Gaskell collected her stories into this single volume “to preserve them from oblivion” arguably mimics my own most fundamental rationale for bringing the figure of the invalid into the analytical spotlight.2 Her structuring of the stories is similarly noteworthy, for, as Edgar Wright explains, Gaskell wanted to present them in “chain format,” an “old method” that had been popularized by Dickens (vii). “The idea she came up with,” Wright observes, “was that of a regular weekly evening gathering of friends round the sofa of an invalid, Margaret Dawson, to whom the narrator had been introduced ‘long ago’ when sent to Edinburgh for medical treatment. It is the unidentified narrator who introduces Margaret Dawson and induces her to recount the story of Lady Ludlow” (433).3 Effacing the invalid’s identity from her title, while positioning a metonymic equivalent for the figure —her sofa—at the volume’s center, Gaskell underscores the capacity of the invalid to be at once culturally invisible and fundamentally pivotal to our understanding of the story. Revealing Gaskell’s trademark interest in the pressures exerted by new world change on old world sensibilities and standards, Round the Sofa recapitulates many of my most central claims about the “story” of invalidism, and so its details are worth stressing. Not least significant is the fact that the narrator of “Round the Sofa”—the brief story designed to introduce the collection as a whole —is also an invalid, a relatively impoverished woman referred to only once as “Miss Greatorex,” who travels to Edinburgh to receive treatment for an “indisposition” that remains unspecified. In Edinburgh she is introduced to a more well-to-do invalid, Mrs. Dawson, who befriends her and eventually tells her the story of Lady Ludlow. Of Mrs. Dawson readers know little other than that she is “obliged to lie in a darkened 1. When referring to the collection as a whole, I italicize the title (Round the Sofa); when referring to the story that introduces this collection, I use quotation marks (“Round the Sofa”). 2. In “‘Round the Sofa’: Elizabeth Gaskell Tells Stories,” J. R. Watson notes also that Gaskell found in the single volume an opportunity to “engage in some interesting preoccupations of her art” (90). 3. Wright makes a mistake here in referring to the narrator as “unidentified.” At one point in “Round the Sofa” she is referred to as “Miss Greatorex.”

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room” (437). Later, within My Lady Ludlow, she will refer to “the pain in [her] hip, which has ended in making [her] a cripple for life” (33). Gaskell’s intentionally vague rhetoric about what is wrong with these two invalid narrators is significant, for coupled with their relative anonymity, their vague medical disorders and unclear social status reinforce one another; invalidism has the power, Gaskell implies, to destabilize, reposition, and in some instances subsume the categories of identity that her readers would have believed to be absolutely central to their understanding of personhood and of a person’s place in the social order. Associating personal identity with the indefinite is just one of several ways that Gaskell captures her culture’s interest in the invalid’s power to signify ambivalence. She also stresses the shared but unspoken understanding that exists between the two women; together they function as an “imagined community” not unlike the one that existed between invalid authors and their “fellow sufferer” readers throughout the century. Moreover, by having the younger invalid serve both as the catalyst who elicits Margaret Dawson’s story and as scribe —she “write[s] out on Tuesday mornings all that [she] had heard the night before” (440)—she implies that the invalid maintains and preserves the old amid the new. Protesting that it might be “too long a story,” Mrs. Dawson describes her tale as “an old-world story which, after all, would be no story at all, neither beginning, nor middle, nor end” (440); and in My Lady Ludlow she twice apologizes for having “wandered away from time and place” (41). Elizabeth Gaskell could not have found a more apt way to capture invalidism’s inherent challenge to the ideals of resolution and closure embedded within traditional linear narrative. J. R. Watson has commented on Gaskell’s penchant in Round the Sofa for “disrupting any inevitable sense of causal or moral progress” (63). Linking the “narratable” to moments when a previous time of stability is disrupted, D. A. Miller’s Narrative and Its Discontents provides a useful paradigm through which to appreciate this dimension of Gaskell’s technique. Describing the invalid’s narrative as an “old world story” that nonetheless has “neither beginning, nor middle, nor end,” Gaskell represents its dual capacity to comfort and to threaten. Functioning as passages that occur between, and hence connect, stories in the volume —the so-called links in the chain—the invalid’s narrative becomes both structurally and thematically something that simultaneously marks and overcomes disruption. Accorded an undeniably privileged position and perspective within domestic and narrative space, her invalid nevertheless undermines the promise of restorative change: “And in the middle of all this was placed the sofa, on which poor Mrs. Margaret Dawson passed whole days, and months, and

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years,” Gaskell writes (438). The significance of this remark becomes even more apparent when placed in its complete context. Gaskell does not simply stress that Margaret Dawson lives in her brother’s home, she describes that home as follows: “Mr. Dawson had acquired much riches in his profession, and his house gave one this impression. In the corners of the rooms were great jars of Eastern china, filled with flower-leaves and spices” (438). By placing Margaret Dawson, on her sofa, “in the middle of all this,” Gaskell makes possible more complex interpretations of her role and status. Does she signify and affirm the value of the objects that surround her—objects that testify to the homeowner’s command—or is she deliberately positioned as subordinate to that power? Or might she be seen, by virtue of her invalidism, to call that power into question, in essence to invalidate it? Whatever the case, Gaskell takes particular care to emphasize the invalid’s position at center stage of the social space; the narrator describes the “old-fashioned house” and “the large square drawing-room, into the center of which Mrs. Dawson’s sofa was drawn” (437). Although Gaskell’s grammar gestures to the passive, Mrs. Dawson is, of course, active in her role as lead storyteller, the narrator of My Lady Ludlow, which opens the body of the volume. Here, too, in her juxtaposition of the active and passive —the capacity for agency coexisting with a posture of submission—Gaskell captures a complexity that is key to invalidism more generally. And the particular care she takes to stress Mrs. Dawson’s own narrative standards becomes more meaningful when understood as part of this larger purpose. By having Mrs. Dawson demand in recompense for her own story something “interesting, which [her audience] had either heard, or which had fallen within [their] own experience” (440), Gaskell raises basic questions of authenticity, only to deflate them, and implicitly suggests that the believable story once heard is as worthy of circulation as the ostensibly more factual, verifiable account. Signifying the specter of the inauthentic even as the figure is accorded a prophetlike capacity to speak truth (we learn that “with Mrs. Dawson every word was a pearl or a diamond” [439]), the invalid, as Gaskell seems to understand, embodies epistemological uncertainty.4 Two features of Mrs. Dawson’s characterization enable Gaskell to further emphasize this uncertainty. In her representation of Margaret Dawson 4. The dating of Round the Sofa becomes particularly interesting in this light, for Gaskell put the volume together just after her controversial biography The Life of Charlotte Brontë was published and critiqued for its authenticity and accuracy. “‘For the future I intend to confine myself to lies,’” she wrote to William Fairburn (qtd. in Watson 95). Watson compellingly links this episode to Gaskell’s metaconsciousness about fiction, art, story, and lies in Round the Sofa.

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as an invalid and in her depiction of the domestic space she inhabits, Gaskell deliberately underscores the idea of the old. Through the younger invalid narrator’s retrospective and nostalgic visions, the Dawsons’ house is situated “in the Old Town” part of Edinburgh and is described as “oldfashioned.” Mr. Dawson is a self-described “old fogie,” and Mrs. Dawson is an “old maid.” Mrs. Dawson’s narrative about Lady Ludlow is, as I have already mentioned, introduced as “an old-world story.” And My Lady Ludlow begins with Mrs. Dawson’s declaration that “I am an old woman now, and things are very different to what they were in my youth” (1). Yet Mrs. Dawson is also uncannily young: she “must have been sixty; and yet her face looked very soft and smooth and child-like,” her invalid protégée tells us (438). Gaskell has recourse here to invalidism’s capacity to signal anxiety about aging and agedness, an anxiety that surfaces in various ways throughout the invalid literature of the period. John Addington Symonds’s thoughts on a windswept hill in Switzerland are equally characteristic of invalidism’s imbrication with age anxiety. Pondering the natives of Davos celebrating New Year’s Eve to tolling church bells, he asks: Was their old age warmed, as mine was, with that gust of life —the young men who had clung to them like bees to lily bells, and shaken all their locked-up tone and shrillness into the wild winter air? Alas! how many generations of the young have handled them; and they are still there, frozen in their belfry; and the young grow middle-aged, and old, and die at last; and the bells they grappled in their lust of manhood toll them to their graves, on which the tireless wind will, winter after winter, sprinkle snow from alps and forests which they knew. (“Winter Nights at Davos” 454)

While many invalids likened invalidism to “premature old age” (the phrase is from Robert Louis Stevenson’s “Ordered South”) or to “premature decay” (the condition William Russell warned against in An Invalid’s Twelve Years’ Experience in Search of Health), others constructed the invalid experience around temporary and transient moments of rejuvenation, a paradigm that seems to have appealed particularly to male invalids (recall Henry Matthews recollecting his boyhood amid the ruins of Rome in his Diary of an Invalid ). Cured by his experiences with hydropathy, Bulwer-Lytton tells readers of Confessions and Observations of a Water-Patient that he hoped now to enjoy “my real, my younger, youth” (10). Frederic Myers published his poem “On an Invalid” in a volume titled The Renewal of Youth. Anxiety about age surfaces not only in narratives and poems written by invalids but also in literature of the period that addresses the threat of invalidism. In a Sat-

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urday Review essay titled “The Fashionable Woman,” for instance, Eliza Lynn Linton excoriates the social schedule and demands of the fashionable woman and writes, “After a certain time of such an existence, can we wonder if her complexion fades and her eyes grow dim? And if that inexpressible air of haggard weariness creeps over her, which ages even a young girl, and makes a mature woman substantially an old one?” (185). Noting the irony of the Victorian preoccupation with old age “in an era obsessed with youth, energy, activity, and progress,” Teresa Mangum finds that writers and artists depicting old age had to negotiate “extremes of expected veneration and practical neglect” (98), parameters that might equally describe cultural attitudes toward the invalid at different junctures of the nineteenth century. Yet in her characterization of Margaret Dawson—remarkably young in her appearance while confidently old in her attitudes and values— Gaskell grapples with the more complex capacity of the invalid to signify neither agedness nor youth, but rather a static position between the two. The capacity to connote stasis lies at the root of invalidism’s emphasis on immobility as well. When in Round the Sofa we learn that Mrs. Dawson lives “without the power of moving by herself,” we get one of Gaskell’s most trenchant invocations of her culture’s fascination with invalidism. The story of Lady Ludlow is, in fact, provocatively filtered through the invalid narrator’s memory of coach travel in her youth—“making a two days’ journey out of what people now go over in a couple of hours with a whizz and a flash, and a screaming whistle” (1). Consoling herself, and perhaps Gaskell’s earliest audiences as well, that despite these “improvements” in travel, “you will never meet with a Lady Ludlow in these days,” Margaret Dawson becomes Gaskell’s mechanism for representing invalidism’s power to function as an antidote to fantasies of social mobility.5 Yet as the embodiment of immobility she, like the invalid figure more generally, garnered all the symbolic power (and agency) implied in the verb form of the term. To immobilize is, after all, to prevent—that is, to will away—freedom of movement (or progress), to reduce or eliminate motion (or change), and to withhold from circulation, an especially significant dimension of meaning when viewed in light of the proliferation of invalid narratives at a time when industrialism so depended on the circulation of goods and capital. It is thus appropriate that the invalid narrator of “Round the Sofa” tells no story herself but rather 5. For a related discussion of how deviant bodies speak to Victorian beliefs and anxieties about social progress, see Erin O’Connor’s Raw Material: Producing Pathology in Victorian Culture. Where she finds in images of “the prosthetic man” and “the armless wonder” an embodiment of “a fantasy of social mobility” (200), I find in the figure of the invalid anxiety about, and in some cases rejection of, this fantasy.

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serves an intercalary function, linking the existing narratives but in effect disappearing from the stories themselves. Margaret Dawson complicates this role considerably; although she reminds her audience both indirectly in “Round the Sofa” and directly in My Lady Ludlow that hers is also “no story” at all, she in essence initiates the circulation and exchange of stories among the group. Invalidism and Identity in Nineteenth-Century Britain argues that the invalid served similarly complex and seemingly incongruent functions. In Round the Sofa, Elizabeth Gaskell used the figure of the invalid and its associations with immobility and invisibility to frame a variety of questions central to the stories contained within her text, and it is through these two concepts—keynotes of invalid literature —that I can hypothesize in conclusion about invalidism’s function in nineteenth-century culture. Either ensconced in darkened sickrooms or forced away from home “in search of health,” invalids were inextricably associated both with isolation—in an age increasingly haunted by the threat of “the crowd”—and with the less visible, with exiled or otherwise marginal places in a domestic and geographic imaginary that dominated nineteenth-century culture. Harriet Martineau hints at the psychic and emotional equivalent of this position when in Life in the SickRoom she describes invalids as “rest[ing] halfway between” life and death (110). Martineau gestures toward a liminal middle space, and though in characteristically grandiose fashion she constructs that space between nothing less than life and death, other ideas and conditions functioned in parallel fashion to bound the experience and idea of invalidism in nineteenthcentury culture —among them, as we have already seen, youth and old age. The culture of invalidism can be understood as emerging out of and instantiating a response to conflicting impulses within nineteenth-century intellectual and social life, particularly those, I argue, with evolutionary or teleological presuppositions. Invalidism might be seen, for example, as evidence of the inability of nineteenth-century society to reconcile its expectation of progress with evidence of degeneration.6 This is not to argue that invalidism was caused by such conflict, whether that conflict is implicit in rhetoric or somehow enacted in public and institutional life; rather, such seemingly irreconcilable conflicts helped to create an environment conducive to the cult and culture of invalidism. Progress and degeneration (or the related binaries of acceleration and decline) are just one among other 6. In Victorian People and Ideas, Richard Altick makes the important point that “the more thoughtful Victorians challenged the identification of change (process) with improvement (progress)” (110). His discussion of the Victorian interest in “other kinds of movement” provides a fascinating backdrop to my analysis of stasis and inertia in the discourse of invalidism.

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sets of oppositional terms present in a range of discourses that at various points and in particular situations throughout the century remained unreconciled. Foucault’s association of the nineteenth century with the advent of a new “medical bipolarity” defined by the opposition of the normal with the pathological speaks to such tensions: “Consciousness lives because it can be altered, maintained, diverted from its course, paralysed,” he writes. “Societies live because there are sick, declining societies and healthy, expanding ones; the face is a living being that one can see degenerating; and civilizations, whose deaths have so often been remarked on, are also, therefore, living beings” (35). Less concrete than the rhetoric of progress and degeneration, but every bit as powerful, were the threats of impoverishment that competed with the mandate for improvement to dominate thinking about personal success and social life. Nineteenth-century Britain produced no grand solutions to these rhetorical conflicts, and their invisible presence and seemingly inevitable irresolution produced instead a kind of cultural inertia with an equal ability to fascinate. The invalid, so clearly an embodiment of inertia, may have succeeded to cultural prominence precisely because the figure seemed to counteract the pressures for choice, resolution, and certainty generated by conflict itself. I have argued that invalids embodied inertia, and here in conclusion I want to speculate that invalidism should be seen as symptomatic of its epoch, as a response of nineteenth-century Britain to the gradual encroachment of modernity, that “coveted and yet feared” phenomenon.7 Agonizing that “the fittest survive, but many drop out of the race,” Robson Roose concluded his 1886 essay “The Wear and Tear of London Life” by suggesting that individuals wanting to “lessen the wear and tear of modern life” reject “a life without leisure and without pause” (202, 208). The contemplative life he proposes as an alternative is one characterized by the dual impulses of retrospective and anticipatory vision—a life “with time to reflect where we have been and where we intend to go, what we have done and what we plan to do” (208). If invalids were made invalid by the very conditions of encroaching modern life that Robson Roose and so many of his contemporaries deplored, the greatest irony is that they were so uniquely suited to encounter, contend with, and resist it. In Invalidism and Identity in Nineteenth-Century Britain, I have asked my readers to gather round an imaginary sofa, to visualize there a figure either 7. The phrase is from “Passing On: Death,” by Gerhard Joseph and Herbert F. Tucker, in A Companion to Victorian Literature and Culture (122).

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erased from or obscured by history, and to allow that figure’s voice to help direct a story at once medical, social, and literary in its implications and consequences. In his influential essay calling for medical historians to bring “the patient’s view” into focus, Roy Porter predicted that “a people’s history of health” would bring into focus something far less monolithic than what more traditional histories had yet to offer and that such a history would show sufferers to be far more “fertile in their resources” than yet recognized (“Patient’s View” 194). The rich and varied legacy left by nineteenth-century invalids more than fulfills this expectation, not only yielding a varied and heterogeneous array of textual resources, but manifesting astonishing fertility in the authors’ own self-fashioning.

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INDEX

“able-bodiedness,” 43 Adair, James, 70 Adams, James Eli, 112n advertising, 14, 53, 145n14 advice manuals, 2, 18, 48–49, 62 “Aesthetics among the Alps” (Blackwood’s), 152 Ainsworth, William Harrison, 79, 83, 84, 88–89 Allbutt, Clifford, 146–47 “Alpine Diversions” (Stevenson), 150, 152, 153 Alps, 141–55 passim; Henry Matthews and, 137; mythic status of, 128–29; symbolic boundaries of, 148 alternative medicine. See medicine: alternative Altick, Richard, 158, 251n Among the Boers (Nixon), 116 Andrews, Jane, 42 anaesthetics, 58 “Apology for Idlers” (Stevenson), 43 Arata, Stephen, 103, 112 Armstrong, Nancy, 48–49 Arnold, Matthew, 13, 45 Aspinall, W. B., 119, 140 –41, 147–48 Athenaeum, The, 234 Augustine, Saint, 68, 68n5, 69n, 99 Austen, Jane, 16 autobiography: and confessional narratives, 68–69; and individualist self, 62; and market society, 62n; spiritual, conventions of, 209; Victorian women

and, 232; as symptomatic texts, 66n. See also Augustine, Saint; Rousseau, Jean Autobiography of Elizabeth Squirrell, The, 171, 209 “Bachelor Invalids and Male Nurses,” 203, 234 Bailin, Miriam, 3; on absence of medical terminology in sickroom fiction, 163; on behavioral codes of illness, 178; on deathbed scenes, 178n; on Evangelical valorization of suffering, 33, 160; on nursing, 25; on Nightingale, 38–39; on patterns in Victorian fiction, 13; on sense of closure in sickroom, 182; on sickroom as “consoling community,” 182, 183 Banks, Olive, 24 Barker-Benfield, Ben, 85–86, 87 Barker-Benfield, G. J., 45n, 65, 73 Beddoes, Thomas, 102 “Bedridden Sick Young Woman” (Engleheart), 29 Beeton, Isabella, 179–81 Bending, Lucy, 159, 167 Bentley’s Miscellany, 120 Bethlem Royal Hospital, 73 Between Two Oceans (Harry), 146 Bible: as contents for commonplace books, 160 –61; in Letters from a Sick Room, 163; reading of, 36; as resource for invalids, 31, 121, 172 279

280

Index

Bird, Isabella, 118 Bitter Cry of Outcast London, 40 Black, C. Allan, 57 Blackwood’s Edinburgh Magazine, 22, 152 Blake, Henry, 115, 121 Book of Common Prayer, 27, 160, 166 Book of Household Management (Beeton), 179–81 Bower, John Wilson, 44 Bradley, Ian, 34 Bradshaw’s Invalid’s Companion to the Continent, 123 Brett, Robert, 40 –41, 158, 163–64, 177– 78, 183–84 Brief Biographies (Smiles), 218 Brief Letter of Advice to an Invalid, A, 129 British and Foreign Medical Review, 218, 220 British Medical Journal, 221n, 224n Brody, Howard, 214n Brooks, John Lee, 44 Broughton, Trev Lynn, 178–79n, 222, 225, 229n11, 231 Brown, Ford Madox, 44 –45 Brown, Gillian, 62n Brown, Horatio F., 20, 101, 105 Browne, Janet, 46, 76–77 Browne, Sir Thomas, 68 Browning, Elizabeth Barrett, 3, 12, 14, 24 Buckton, Oliver, 67n3, 68, 100n22, 101 Bullar, William, 116 Bulwer-Lytton, Edward, 21, 75–92, 159; advice to “fellow sufferers,” 53; contradictory emotions of, 217; as editor of the New Monthly Magazine, 75, 85; health history of, 85; recovery of, 102; similarity of “Confessions” to Symonds’s Memoirs, 106, 108, 111; response to market economy, 157. See also “Confessions and Observations of a Water Patient” Bunyan, John, 68, 121 Burgess, Thomas Henry, 113, 114 –15, 129, 130 Burnett, John, 40n, 42, 43 Burns, Jabez, 158 Buzard, James, 119–20n, 120, 124n, 137 Bynum, W. F., 52, 164 –66

Campbell, James, 78 Campbell, Thomas, 18, 78 Canguilhem, George, 106–7 “Caricature of an Invalid Strapped into a Special Chair,” 35 Carlyle, Thomas, 76; “Characteristics,” 11, 61, 220; on Harriet Martineau, 220, 225, 232–33; ideal of work, 40, 44 –45; Past and Present, 40 Carrington, E. F. J., 68 case-taking. See medicine: and case-taking Chadwick, Edwin, 51 Chadwick, Ellen, 191–99; background of, 192–93; Christmas dispatches of, 194; compared to Martineau, 230; depiction of sickroom, 193–96; influence of Evangelicalism on, 33; posture of resignation, 197; pronounced “incurable,” 192; public role of, 21; readership of, 78n; and rhetoric of schooling, 31; Echoes from a Sick Room, 191, 195–97; and usefulness of books, 37; on virtue of acquiescence, 189; visitors to, 196; Weak, Yet Strong, 166, 191–94; and work, 41 Chamber’s Journal, 30 Champney, L. W., 118 “Characteristics” (Carlyle), 11, 61, 220 Cheyne, George, 29–30 Child’s Garden of Verses (Stevenson), 44 cholera, 51 Christian Examiner, 206–7 Christian invalids, 156–99; as “longsuffering,” 179; and market economy, 157; as “post-patients,” 166, 169; “requirements” of, 179–82; and rhetoric of resignation, 157; and rhetoric of schooling, 190; and salvation, 159; sick role of, 162–64, 179. See also Chadwick, Ellen Christian Observer, 167 Christian Treasury, The, 188 “Christ’s Hospital” (Lamb), 75 Clark, James, 126, 129 class. See invalidism: and stigma of idleness; invalidism: as middle-class phenomenon; Martineau: and class unconsciousness; men: and work; middle

Index

classes; women: and work; work; working class Climate of Italy (Burgess), 113, 114 –15, 129, 130 climatotherapy, 7, 125–31, 146–47, 171 Clouds and Sunshine (Townsend), 12n, 30n Cobbe, Frances Power, 49, 105n, 208 Colley, Ann, 76n Collins, Wilkie: contrast to Martineau, 234, 238; Heart and Science, 45; “Laid Up in Lodgings,” 4, 24, 201–12 passim, 237–40, 242–43; in Mr. Nightingale’s Diary, 72n; and water cure, 76; Woman in White, 17, 31 Colorado Springs, 146–47, 148, 156–57 Colp, Ralph, 21, 38, 41, 43, 46 commonplace books, 18, 59, 158, 202, 211n; contrast to “life in the sickroom” narratives, 211n; conventions of, 161, 179, 186–89; and Evangelicalism, 162, 185–86; history of, 160; Life in the Sick-Room and, 233; medical information in, 162–63; readership of, 161– 62, 183, 188; role of Christ in, 163– 66; and self-examination, 184 –86; and self-help, 160, 162; and sick role, 162, 183, 189; as useful, 160 –61; and women, 189 Companion for the Sick Chamber (Thornton), 158 conduct books. See advice manuals confessional mode, 2, 6–7, 63–65, 112. See also Confessions of a Hypochondriac; Bulwer-Lytton, Edward; Symonds, John Addington confessional narratives: and anti-Catholicism, 68n6; association with spiritual texts, 68; authenticity of, 69–70; autobiographical nature and, 67; Evangelicalism and, 64; popularity of, 69; reader role in, 67. See also Augustine, Saint; hypochondria; Rousseau, Jean Confessions (Rousseau), 99 Confessions (Saint Augustine), 68, 68n5, 69n, 99 Confessions of an Apostate (Flinders), 68 Confessions of a Catholic Priest, 68 Confessions of a Coward and Coquette, 68

281

Confessions of a Detective Policeman, 64 “Confessions of a Drunkard” (Lamb), 68, 69, 72, 75 Confessions of an English Opium-Eater (De Quincey), 67 Confessions of a Hypochondriac, 91–98; author advised to travel for health, 128; and confessional form, 67; doctorpatient relationship in, 93; and fringe medicine, 28–29; ghost metaphor in, 83; idleness in, 94 –95; language of sensations in, 65; and market economy, 97; medical language in, 46, 92; and overwork, 97; and quackery, 53, 94; response to market economy in, 157; sexual health in, 97; Symonds’s Memoirs and, 106, 108, 111; as symptomatic text, 66; theme of manhood in, 96–97; theme of inertia in, 92, 93, 95 Confessions of a Medium, 64 “Confessions and Observations of a Water Patient” (Bulwer-Lytton), 65, 75–92, 98; alienating marketplace and, 97; armor metaphor in, 89; ghost metaphor in, 83; kinship to Lamb’s “The Convalescent,” 217; medicalized language in, 81; pamphlet version of, 78–79, 80; readership of, 79; sexual anxiety in, 87 Confessions of an Old Bachelor (Carrington), 68 Confessions of an Old Maid (Carrington), 68 Confessions of an Old Smoker, 68 Confessions of a Scribbler, 64 “Confessions of a Toad-Stool Eater,” 68 Confessions of a West-End Usurer, 64 Confessions of a Woman, The, 68 consumption, 3, 7, 33, 51; acquisition and, 8, 65n; climate and, 145, 149; Emily Shore and, 127; histories of, 3, 145n15; social attitudes to, 31, 117; symptoms of, 7; John Addington Symonds and, 20, 98–99; terminology for, 128n; and travel, 16 “Convalescent, The,” 238 “Convalescent, The” (Lamb), 18, 64, 201– 12 passim; egotism in, 61, 66, 217; stasis in, 12–13, 207, 214 –18 cookbooks, 16, 181

282

Index

Cornhill Magazine, 17, 18, 36, 202 Coupland, W. C., 104, 105n, 109n Craft, Christopher, 17n1 Craik, Dinah, 30 –31 Cranford (Gaskell), 245 Crown of Wild Olive (Ruskin), 40 Cruikshank, George, 13 Cup of Consolation, The, 157, 158, 162, 182; biblical and literary intermingled in, 186–87; readership of, 187–88 Daisy Chain (Yonge), 16–17, 45–46, 163, 165 Dale, Peter Allan, 98 Dallas, E. S., 105n Danahay, Martin, 155n “Danger of Idleness, The,” 43 Dark Lantern, A (Robins), 199n Darwin, Charles, 3, 12; diagnosis of, 46; health journal of, 18; identity as invalid, 21, 38, 44; and water cure, 76; work schedule of, 41, 43 Darwin, Sir Francis, 44 David Copperfield (Dickens), 60 Davidoff, Leonore, 39–40, 43–44, 48, 89n Davos, 99, 114, 119, 146–47 “Davos in Winter” (Stevenson), 150, 152 “Davos in Winter” (Symonds), 129n, 130, 145–53 passim Davos-Platz, A New Swiss Retreat, 147 deathbed scenes, 178–79n Denison, Lord Albert, 119, 121–29 passim, 140; on allegorical significance of journey, 121; guidebook as chronicle, 147 DeQuincey, Thomas, 67–68 Devotions for the Sick Room (Brett), 40 –41, 158, 163–64, 177–78, 183–84 diagnosis, 4, 5, 59; retrospective, 20 –21; self, 29; tools of, 5, 55 Diary of an Invalid (Matthews), 113–40 passim; doctor-patient relationship in, 136; “England” in, 132–34, 154; “English eye” motif in, 132; medical information in, 135; moments of rejuvenation in, 249; nationality in, 131; patient power in, 53; readership of, 116, 132; self-reflexivity in, 138; theme of inertia in, 139 Dickens, Charles, 60, 72–73, 180, 246

Dictionary of Psychological Medicine, 73, 104, 105n, 107, 167 Digby, Anne, 24 –25, 29, 36n, 52–53, 59, 90n “disappearance of the patient,” theories of, 55–56, 164 –66. See also medicine: rise of scientific Distad, Merrill, 119–20 “Doctor, The” (Fildes), 35–36 doctor-patient relationships, 5, 32, 51–60 passim, 171–72n, 187. See also medicine: rise of scientific Dodd, William, 41, 42 domestic ideology, 7, 13, 33, 47–48, 50, 84. See also women: femininity, ideologies of Douglas, C. Home, 23, 118, 119, 140 –41 Dowling, Linda, 103, 106 “Dr. Wilson’s Water Cure Establishment” (Goodall), 81 Dublin University Magazine, 220, 221 Dubos, Jean, 123, 128n, 149 Dubos, Rene, 123, 128n, 149 Duckworth, Julia (Mrs. Leslie Stephen), 25, 181–82 Du Maurier, George, 13 Echoes from a Sick Room (Chadwick), 119, 195–97 Edgeworth, Maria, 28 Edinburgh Royal Infirmary, 205 Edwardes, Charles, 30, 115, 155 Effects of Arts, Trades, and Professions, The (Thackrah), 75 Ehrenreich, Barbara, 49 Eliot, George, 22 Ellen Chadwick: The Famous Manchester Invalid, 37, 191–99 Ellis, Havelock, 111 Engleheart, Francis, 13, 29 English, Deirdre, 49 epidemics. See health: public Epstein, Julia, 52n, 228 Essay on the Conduct of a Physician (Black), 57 Evangelicalism, 4, 16–17; and atonement, 198; and beliefs about work, 38–40, 43; and Christian invalids’ agency, 185–86; as context for invalidism,

Index

32–33, 43, 46, 60; and deathbed cult, 178n; dating of Revival, 32n; and God, 160; and hymn singing, 173; and pain, 158–60; publications associated with, 27; and self-help, 171–72n; and spiritual transformation, 5; valorization of resignation, 149 Every Man’s Assistant and the Sick Man’s Friend (Stonhouse), 169 Experiences of an Invalid, by One Who Cured Herself, 58 “Famous Manchester Invalid.” See Chadwick, Ellen Fancies of a Whimsical Man (Townsend), 44, 157n Feldberg, Georgina, 145n15 Few Thoughts on the Serious Character of the Object of a “Yearly Meeting,” A, 18 Fildes, Luke, 35–36 Fischer-Homberger, Esther, 69, 73n Fissell, Mary E., 56, 158n, 164 Flinders, Anne, 68 Flint, Kate, 160 Forbes, John, 127 Fortnightly Review, 18, 142, 143, 144, 221n Foster, Dennis, 67 Foucault, Michel, 217, 228–29, 252 Fraser’s Magazine, 116, 202, 234 Freccero, John, 13 Freud, Sigmund, 109 fringe medicine. See medicine: alternative; hydropathy “From the Sickroom Window,” 204 Froude, James, 245 Frye, Northrop, 69n Garnier, H., 25, 26 Gaskell, Elizabeth, 17, 245–51 Gates of Praise (Macduff ), 186n Gay, Peter, 18 Gefland, Toby, 9 Gems of Sacred Poetry, 188 Georgian artists, 35 Georgian medicine, 46, 52–54 passim, 80 Georgian satire, 218 Giles, M., 156, 185–86, 188–89, 197–98 Gilman, Charlotte Perkins, 198–99

283

Gilmour, Robin, 32n, 159, 173 Gissing, George, 31, 40, 47 “Goblin Market” (Rossetti), 75 gout, 3, 31, 35 Grace Abounding (Bunyan), 68 Gray, Janet, 161n Greenhow, T. M., 221n, 231 Grosskurth, Phyllis, 99 Gully, James, 46, 80, 90 Guthrie, Douglas, 2n Hacking, Ian, 8, 19–20, 32, 59, 117 Haley, Bruce, 3, 17; on cholera, 51; on health and labor, 39, 40; on “higher health,” 61, 154; on hydropathy, 76n, 95; on hypochondria, 69; on physical exertion, 151 Hall, Catherine, 39–40, 43–44, 89n Hard Times (Dickens), 180 Harris, Jose, 38n, 39, 40, 43–44, 46 Harrison, H. B., 37, 191–95 Harry, Iza Duffus, 146 Hartley, David, 105 Hawkins, Anne Hunsaker, 162–63 Hayman, S., 221 health: as marketable ideal, 14; hydropathy and, 90; industry and, 65; physical, 61; public, 50 –51; and social life, 8; as subject matter, 17–18. See also Haley, Bruce; invalidism; invalid narratives: search for health motif in; sexuality: female; sexuality: male “Health and Mountains” (Stevenson), 146, 148, 150, 152, 156–57 health resorts, 129n, 150 –51, 155. See also Alps; Davos; Malvern; Mediterranean “Health-Resort Vignettes” (Edwardes), 30, 115, 155 “Health-Seeking in Tenerife and Madeira” (Mackenzie), 120, 123, 125, 130 Heart and Science (Collins), 45 Hefland, Mrs. 74, 127 Heller, Tamar, 2, 3n3 Henley, William Ernest, 27, 54, 201–11 passim, 225 Henslowe, Fanny, 11–12, 158, 159, 161, 182, 189 Herndl, Diana Price, 23, 50, 198n10, 229 Herzlich, Claudine, 117

284

Index

“Hetty’s Pretty Face,” 34 Hilton, Boyd, 159, 171n Hinde, Thomas, 80 Hints from an Invalid Mother to Her Daughter (Williams), 48 Hogg, James, 67–68 Holubetz, Margarete, 178n Home Journal, 30 “Hooper’s Invalid Bed-Lift,” 16 Hopkins, Louisa Payson, 158, 161, 179, 183–86 Horner, Jonah, 77–78 “Hospital Life” (Ward), 160, 210, 240 –41 household manuals, 16 Household Words, 237, 238, 246 How to Observe Morals and Manners (Martineau), 227 Humphrey Clinker (Smollet), 135n Hunt, Leigh, 73, 83 Huxley, Thomas Henry, 12 hydropathy, 31, 53; Bulwer-Lytton and, 76–92 passim, 111; cartoon of, 77; healing potential of, 78; medical community and, 90; natural pleasures of, 87 Hygeia (Beddoes), 102 hymnals, 2, 16, 18, 62, 172. See also Invalid’s Hymn Book, The Hymns Ancient and Modern, 173 “Hymns for the Time of Weakness,” 33 “hyperaesthesia,” 107 hypochondria: appeal of confessional narrative and, 69–75; businessman and, 75; climatotherapy and, 129; cult of, 49; definitions of, 70; gendered identity and, 74; history of, 73; hydropathy and, 82; idleness and, 94 –95; market economy and, 74; nervous disorders and, 6–7 hypochondriac: and Christian invalid, 171; as consumer, 93; figure of, 12, 32, 69– 75, 91, 95; self-diagnosis and, 94; skepticism of medical community to, 70 –72; Tennyson as, 76n. See also Confessions of a Hypochondriac “hypochondriasis,” 72, 73, 108 hysteria. See sexuality: female; sexuality: male

Idle Hours of an Invalid, 12 Illustrated Europe: Davos Guide Book, 148– 49 industrialization, 5, 31, 38–42, 60, 215; and categories of work, 5; as context for invalidism, 1, 5, 32, 212; and masculinity, 216–17; response to by Lamb, 216–17; and work ethic, 38–48, 60. See also medicine: market economy; “wear and tear complaint” “In Hospital” (Henley): attitude toward visitors in, 27, 201–5 passim; depiction of invalid’s alertness in, 225; linear format of, 209, 210; scientific medicine in, 54 Instruction to the Invalid on the Nature of the Water Cure (Horner), 77–78 Interpretation of Dreams (Freud), 109 “Invalid Abroad, The” (Lindon), 120 –21, 129 “Invalid Chairs,” 15 invalidism: aestheticism and, 119; age and, 155, 249–50; agency and, 7, 8, 125, 229, 248, 250; American experience of, 9, 28n, 33–34, 120, 123, 146; and capacity, 1, 6, 8, 23, 41, 46; contexts for understanding, 31–63; culture of, 3, 6, 12, 13, 18, 31, 251; culture of suffering and, 60 –63; definitions of, 22–24; and disability, 9; “ecological niche” of, 8; experience of for children, 14; experience of for men, 7, 43–48, 84; experience of for women, 7, 14, 24, 25, 40, 49–50, 189, 198–99; and femininity, 45, 157; iconography of, 7, 13, 35–36; industry of, 14 –16; infantilizing nature of, 181, 217; and interiority, 8, 61, 62, 183, 200 –244 passim; and market economy, 157, 243; and masculinity, 44, 76, 118; meanings of, 22–23; as medical condition and social role, 3, 6, 12, 21, 115, 205, 247; and medical history, 2–4; as middle-class phenomenon, 12, 42–44, 84; and nationality, 6, 118–19, 131 (see also Matthews, Henry); occupation and, 86; productivity and, 1, 8; and stigma of idleness, 38, 43; and spiritual transformation, 5;

Index

tourism and, 120 –55 passim; and work ethic, 39–43; working-class experience of, 25, 42. See also climatotherapy; hypochondria; sick role “Invalid Lodger, The,” 213 invalid narratives: and anonymity, 4, 17; autobiographical nature of, 62; “beaten track” motif in, 124 –24, 141; confessions as, 7, 63; crisis and recovery paradigm in, 4, 13, 209–10, 247; doctor-patient relationships in, 56; indeterminacy and, 166n; interiority in, 7, 201–44 passim; medical information in, 4, 46, 59; public documents as, 18; readership of, 4, 6, 11, 18, 62, 78n, 149–50; rhetorical strategies in, 5, 62, 117–18; rise of scientific medicine and, 52; search for health motif in, 7, 113–55 passim, 251; secular style of, 158n; self-help commentary in, 130 – 31; “usefulness” of, 11, 36–38, 178, 208; subjectivity of, 61, theme of expenditure in, 86; theme of stasis and inertia in, 5, 8, 13, 95, 114, 139, 210, 250 –52. See also commonplace books; travel guides invalids: abroad, 16, 115, 118–55 passim; attentiveness of, 210 –11; and authorial identity, 11, 17–21; bodies of, 5, 8, 250n; as businessmen, 234 –44; caricatures of, 35; children, 30; Christian, 8; classification of, 19, 23–24, 30, 126– 27, 169; clinical experience and, 54; as consumers, 14; egotism of, 211–12; ethereal nature of, 203; as fictional characters, 16–17, 31, 60, 72, 246–51; as embodiment of inertia, 5, 8, 12–13, 95, 115, 205, 210, 252; as expatriates, 154; as impostors, 1, 13, 16, 130, 231; as “incurable,” 1, 5, 23–24, 47, 59, 154, 192; as recognizable types, 6, 11, 12, 18–20, 62; rhetorical strategies of, 6, 43; as postpatients, 166, 169; as pilgrims, 34, 121, 158; as prisoners, 202, 205; psychological interest of, 202, 205–6; relationship to readers, 4, 6, 11; requirements of, 13, 16, 123–24, 179–84, 205; resources for, 172–78;

285

as tourists, 7, 117, 120 –31; vehicles for, 6, 16. See also Christian invalids; hypochondriac Invalid’s Hymn Book, The, 163, 173–78, 188 “Invalid’s Notes, and Rambles about Jersey, An,” 116 Invalid’s Own Book, The, 9, 158, 182, 183, 187–88 Invalid’s Twelve Years’ Experience in Search of Health, An (Russell), 53, 74, 75, 117, 249 “Invalid’s World” (Ward), 27, 31, 57–58, 202–3, 240 –43 “Invalid Wives, Our” (Champney) 118 Italian, The (Radcliffe), 139 “Italy: A Poem” (Rogers), 137 It Is Never Too Late to Mend (Reade), 17, 53–54 Jackson, Scoresby, 126 James, Alice, 41 Jameson, Anna, 222 Jay, Elisabeth, 68n6, 173, 178n Jerome, Ambrosini, 37 Jesse, Captain William, 116 Jewson, N. D., 54, 55, 55–56n, 164 Jobson, J., 71 Jones, Billy M., 123n Jordanova, Ludmilla, 3n5 Joseph, Gerhard, 252n Joubert, Joseph, 13, 45 Journal of Emily Shore, 38, 50, 57, 121, 122, 127 Journal of William Swan, 42 Kestner, Joseph, 89 Kingsley, Charles, 61, 146 Kingsley, Rose, 146 Koch, Robert, 145 Krueger, Christine, 37 labor. See work “Laid Up in Lodgings” (Collins), 4, 24, 201–12 passim, 237–40, 242–43; lack of medical information in, 4; performance of sick role in, 24, 237–38; representation of domestic world in, 239;

286

Index

“Laid Up in Lodgings” (Collins) (continued) representation of invalid’s egotism in, 212 Lamb, Charles, 12–13, 64 –66 passim, 75, 212–18, 237; “Christ’s Hospital,” 75; “Confessions of a Drunkard,” 68, 72, 75; “The Convalescent,” 61, 201, 203, 207, 211–12, 214 –18; on egotism of invalid, 214; as Elia, 72, 212; irony of, 234, 235; response to market economy, 157, 215–16; rhetoric of confession and, 66; “Superannuated Man, The,” 75, 214 –15 Lancet, 129n, 146–47 Lane, Christopher, 17n1 Lane, Joan, 67 Lane, Richard: and anxiety about work, 39, 45; and Bulwer-Lytton, 78; relation to doctor, 59; and rhetoric of usefulness, 38, 59, 78, 90 –98 passim Lawless, Emily, 23 Leaves of Grass (Whitman), 100 Lectures on the Physiology and Diseases of the Chest (Williams), 125–26 “Le Malade Imaginaire” (Solomon), 71 Letters from Abroad (Bullar), 116 Letters from a Sick Room, 34, 47, 200; alertness of invalid in, 210; attitude toward visitors in, 25–26; author as “inured to pain,” 211; on autonomy of patient, 56; invalid’s egotism, 211; emphasis on isolation in, 201; expressions of gratitude in, 159; frontispiece to, 163, 164; freedom from working world in, 206, 207; reference to Martineau in, 233; representation of teaching in, 195; rhetoric of usefulness in, 37–38; sickroom as sanctuary in, 179 Letters from Samoa (Stevenson), 41 Letters on Mesmerism (Martineau), 234 Letter to an Invalid about to Visit Madeira, A, 115–16, 121–22, 124, 129–30 Levin, Susan, 67, 68 Levine-Clark, 43 Lewes, George Henry, 17 Life at the Water Cure: Or, A Month at Malvern (Lane), 38, 45, 59, 78, 90 –98 passim Life in the Sick-Room (Martineau), 200 –212

passim, 218–34; beliefs about class in, 230 –31; language of self in, 232; and market economy, 224; physical symptoms in, 58, 59; popularity of, 18; readers of, 62; representation of pain in, 61–62; reception of, 218, 220 –21, 223; representation of invalid’s truthfulness in, 231–32; rhetoric of seeing in, 226– 30, 239; stasis in, 12; structure of, 221; truthfulness in, 231–32 Life of Frances Power Cobbe, 208 Lindon, Simeon, 120 –21, 129 Lindop, Grevel, 67n4 Linton, Eliza Lynn, 250 Lister, Joseph, 205 Literary Gleanings by an Invalid (Henslowe), 11–12, 158, 159, 161, 182; Hannah More passage in, 189 “Literary Pursuits Recommended to Invalids,” 18 “Little Health of Ladies, The” (Cobbe), 49 Little Lucy, the Invalid, 30, 38, 39 Locker, David, 24 Logan, Peter, 3, 43, 63, 74 London Labour and the London Poor (Mayhew), 40 London Magazine, 18, 69, 212, 214, 215, 217 London Times, 14 Lunatic Asylums Acts, 76 Lyall, A., 122n Macduff, J. R., 186–87 Machann, Clinton, 100 Mackenzie, Morell, 120, 123, 125, 130 Macmillan’s Magazine, 18, 114, 144 Macnish, Robert, 107 “making up people,” 19–20, 59 malade imaginaire, 12, 70, 71, 212 malingerer, figure of, 12, 55, 68, 70, 231 Malvern, 76–87 passim, 92, 107, 114. See also “Dr. Wilson’s Water Cure Establishment” Manchester Courier, 194 Mangum, Teresa, 250 Mant, Richard, 27, 166, 167–72, 174 –78 passim, 183 Marcus, Laura, 66n Martineau, Harriet, 23, 24, 34, 200 –201,

Index

210, 218–34; autobiography of, 22, 27, 218; and class unconsciousness, 230; compared to Ellen Chadwick, 230; and Evangelicalism, 218; How to Observe Morals and Manners, 227; Letters on Mesmerism, 234; letters to, 78n; “Letter to the Deaf,” 223; Life in the Sick-Room, 12, 18, 58–62 passim, 203, 218–34; and “overwork,” 222; portrait of, 219; and rhetoric of usefulness, 39; Society in America, 227; and Unitarianism, 220 Mary Barton (Gaskell), 245 Mascuch, Michael, 62 Massingberd, 27 Matthews, Henry, 119–20, 122–24 passim, 127–28, 131–40; credibility as tourist, 133; “England” in Diary, 132–34, 154; guidebook nature of narrative, 147; moments of rejuvenation and, 249; patient power, on, 53; physical health of, 113; skepticism about cure, 145 Maudsley, Henry, 104 Maurice, F. D., 45 Mayhew, Henry, 40 McLynn, Frank, 143n, 144n Mediterranean, the, 123–24, 128–30 medical history: alternative medicine and, 56, 69; class and, 2; invalidism as feature of, 2–5; inventions and, 13– 14; models of, 2–4; relation to religious history, 32, 166n, 167–68; and patient’s perspective, 2, 4, 57; and public health, 50 –52; and retrospective diagnosis, 20 –21; and scientific medicine, 13, 51–55; and sociology; sources for, 3n4. See also consumption; doctor-patient relationships; Georgian medicine; gout; health resorts; hypochondria; Malvern; neurasthenia; “shattered nerves”; symptom pyramid; water spas Medical Reform Acts, 52 Medical Report of the Case of Miss H —— M—— (Greenhow), 221n, 231 medicine: ability to cure, 5, 13, 29, 52; alternative, 29; and case-taking, 52, 52n; inventions and, 13; lay, 23; market economy and, 14 –16, 30, 54, 216; patient power and, 90; profession of, 29,

287

32, 51, 165–66; rise of scientific, 5, 13, 23, 51–55, 58, 77; See also advertising; diagnosis; doctor-patient relationships; patient testimonials Memoirs (Symonds), 98–112, 143, 154 –55 men: bachelor invalids, 203, 206, 234; businessmen invalids, 206–7, 216, 234 – 44; and exertion, 7, 118; gentlemanly ideal, 44; guidebook writing and, 7; ideals of manliness, 8, 44 –45, 65, 73– 84 passim, 89n, 96–97, 118, 149, 157, 241; industrial age and, 89, 216–17; models of identity for, 112n; and rejuvenation, 249; and work, 43–44, 46 (see also Bulwer-Lytton, Edward; Lamb, Charles; Symonds, John Addington); and workplace, 41, 206 (see also sickroom: relation to household). See also hypochondria: and gendered identity; “overwork”; sexuality: male; “shattered nerves”; wear and tear complaint mesmerism, 28, 200n1, 222n Micale, 107 middle classes: ascendancy of, 38; association with invalidism, 42–45; hypochondria and, 74; occupations associated with, 74 –75; and psychosomatic illness, 20; rhetorical strategies of, 43; and travel, 119–20; as water spa clientele, 82; work, 42–43. See also domestic ideology; men: businessmen invalids; men: and workplace; women: and work Miller, D. A., 247 Milnes, Monckton, 227 Mitchell, Sally, 44, 128n Mitchell, S. Weir, 94n, 201–2, 202n, 224, 224n More, Hannah, 156, 189 Morison’s pills, 53, 74 Mr. Nightingale’s Diary (Dickens), 72–73 Mullan, John, 45n Mutterings and Musings of an Invalid (Townsend) 30, 44, 157 Myers, Frederic, 249 My Lady Ludlow (Gaskell), See Round the Sofa Mylne, 27

288

Index

nationality. See invalidism: and nationality National Magazine, 116 nature therapy. See hydropathy; climatotherapy Nead, Lynda, 182 Nemesis of Faith (Froude), 245 nervous disorders, 3, 6–7, 63. See also “shattered nerves” “nervous narratives,” 63 neurasthenia, 49, 82 New Monthly Magazine, 70, 75–92 New Poor Law, 43 Nightingale, Florence: attitude toward family, 47–48; self-designation as invalid, 1, 3, 12, 24; return from Crimean War, 21; sickroom of, 41; work ethic of, 38–39, 41 Nixon, John, 116 North, Julian, 67n4 North and South (Gaskell), 245 Norton, Rictor, 104, 106, 154 Notes from Sick Rooms (Duckworth), 181– 82 Notes of a Half-Pay in Search of Health (Jesse), 116 nursing, 25. See also Duckworth, Julia Observations on Man (Hartley), 105 Occasional Poems. By an Invalid, 77, 189–90 O’Connor, Erin, 250n Odd Women, The (Gissing), 31, 40, 47 “On Being Ill” (Woolf ), 64, 244 Once a Week, 30, 202 Oppenheim, Janet: on ideals of manliness, 80; on overwork, 46, 47; on patient power, 90n; on rest cure, 90n, 224; on “spermatic economy,” 86n; on travel for health, 127–31; on Victorian women’s health, 49–50; on wear and tear complaint, 81 “Ordered South” (Stevenson), 1, 61, 114, 152, 155, 249 Order for the Visitation of the Sick (Mant), attitude toward visitors in, 27, 166, 167–72, 174 –78 passim, 183 Origin of the Species (Darwin), 46 Ott, Katherine, 14 Our Life in the Highlands (Symonds and Symonds), 129, 142, 149–50, 153

Outlines Selected from the Blotting Book of an Invalid, 160, 162 “overwork,” 5, 7, 45–50 passim, 81; and Harriet Martineau, 222; hypochondria and, 97; journalism and, 112; travel and, 127 Overwork and Premature Mental Decay, On (Routh), 45, 80 –81 Oxford English Dictionary, 22–23 “Page of My Life, A” (Symonds), 141–43, 149, 150 Paget, James, 108 Pall Mall Gazette, 144, 156 Parsons, Talcott, 24 –28 passim, 42, 166, 183 Past and Present (Carlyle), 40 pathography, 162–63 patient testimonials, 145, 145n14 Pierret, Janine, 117 Pemble, John, 121, 123, 126, 129 Penny Cyclopaedia, 72, 73–74 Penny Magazine, 43 Perkin, Harold, 44 Peters, Robert L., 107n Peterson, Linda, 235n Philanthropist, The, 69 Philosophy of Sleep (Macnish), 107 “Physician Recommending Medicine to a Young Female Patient, A” (Garnier), 26 Physician’s Holiday, A (Forbes), 127 Pichanick, Valerie, 232 Pickering, 40, 44, 48 Pilgrim’s Progress (Bunyan), 121 “Pleasures of Sickness, The” (Shand), 12, 28, 212, 242 Polson, Nicolas, 116 Porter, Dorothy, 25, In Sickness and in Health, 18, 28–33 passim, 69–70, 158, 170; Patient’s Progress, 51–55 passim Porter, Roy, 52; “Addicted to Modernity,” 65n, 216; Health for Sale, 74, 92–93; In Sickness and in Health, 18, 28–33 passim, 69–70, 158, 170; “Introduction,” 51, 171–72n; “Medical History of Waters and Spas,” 77; “Pain and Suffering,” 55, 58; Patient’s Progress, 51–52, 55; “Patient’s View,” 2, 3n4, 4, 252; on self-help, 172n

Index

“Portrait of Harriet Martineau” (Bowness), 219 Postlethwaite, Diana, 222n, 226 poststructuralism, 5–6, 189 Practical Piety (More), 156 prayer books, 2, 16, 62, 172 Private Memoirs and Confessions of a Justified Sinner (Hogg), 68 “psychical research,” 105n psychosomatic illness, 20, 54 –55 public health. See health: public quackery. See medicine: alternative Quarterly Review, 69 Radcliffe, Ann, 139 Rambles in Madeira and in Portugal (Lyall), 122n Reade, Charles, 17, 53–54 “Recent Travellers” (Fraser’s), 116, 127 Recorded Mercies (Andrews), 42 Religio Medici (Browne), 68 religious faith, 2, 4, 6, 12, 33. See also Evangelicalism; Martineau: and Unitarianism “Religious Melancholia and Convalescence,” 168 Religious Tract Society, 27, 33, 172 “Renegade, A” (Lawless), 23 Renewal of Youth (Myers), 249 rest cure, 199n, 202n, 224 –25. See also Mitchell, S. Weir “R.T.S. Invalid Library,” 27, 33, 34, 46, 172, 173 Risse, Guenter, 54, 164n Robins, Elizabeth, 199n Rogers, Samuel, 137 Roe, Nicholas, 45n Roose, Robson, 46, 75, 252 Rorty, Amélie, 19, 32 Rosenberg, Charles, 2, 51 Rossetti, Christina, 75 Rothfield, Lawrence, 3 Rothman, Sheila: on Evangelicalism, 33; on invalidism as identity, 22, 28n; on “required anecdote” in travel narratives, 146; on social expectations of invalids, 48; on travel for health; 120 –26 passim

289

Round the Sofa (Gaskell), 246–51; and cultural invisibility of invalid, 246; dating of, 248n; as “old-world story,” 247; structure of, 246 Rousseau, G. S., 45n Rousseau, Jean, 69n; 99 Routh, Henry Felix, 45, 80 –81 Rover, 85 Ruskin, John, 40, 76 Russell, William, 53, 74, 75, 117, 249 Sanative Influence of Climate, The (Clark), 126, 129 sanatoriums. See health resorts Sanders, Valerie, 39, 226, 227n San Remo as a Winter Residence (Aspinall), 119, 140, 141, 147–48 Saturday Review, 249–50 Savage, George, 66, 73 Schueller, Herbert M., 107n scientific medicine. See medical history, and scientific medicine; medicine: rise of scientific Searches for Summer (Douglas), 23, 118, 140 –41 “search for health,” 7, 113–55 passim, 166 self-help, 2, 16, 32; in commonplace books, 160; permeation in Victorian culture, 171n, 212; in travel accounts, 130 –31 Self-Help (Smiles), 43, 171n Senior, Jane, 48 sensibility, culture of, 45, 151 Series of Tracts (Nisbet), 188 Sermons: Designed for the Sick Room (Burns), 158 Sexual Inversion (Ellis), 111 sexuality, female: and hysteria, 3, 47, 74, 94n, 107, 198, 224; medical literature on, 49–51. See also rest cure; women sexuality, male: discourses of, 85–89; homosexuality, 17n1 (see also Symonds: beliefs about homosexuality); hysteria, 108; and “sexual inversion,” 1–7, 108; and “spermatic economy,” 85–87; “spermatorrhea,” 108. See also “Confessions and Observations of a Water Patient” Shand, Alexander, 12, 28, 212, 234, 242 Sharpe, Michael, 224n

290

Index

“shattered nerves,” 7, 31, 45, 81–82, 112 Shore, Emily, 38, 50, 57, 121, 122, 127 Shorter, Edward, 16, 55–56n, 58–59 Showalter, Elaine, 49, 198n9, 199n Shuttleworth, Sally, 45, 75, 108 Sick Chamber Companion, 27 “Sick Female Patient” (Jerome), 37 “Sickness and Health” (Webster), 13, 14 sick role, 24 –28 passim, 212; as contingent, 42; and patient role, 59–60, 166; scriptedness of, 4, 178; and sickroom, 206; and social control, 243; as subject of narrative, 201. See also Christian invalid; hypochondriac; invalid; malade imaginaire; malingerer; Parsons, Talcott sickroom: as Christian way station, 197, 202–3; fictional depictions of, 35; as feminine, 7; geographic imaginary of, 8, 201; literature for, 158–59; and market economy, 206–8, 243; as medical space, 228; as otherworldly, 34, 233; relation to household, 203–8 passim; and self-examination, 208; as sanctuary, 179, 202, 207, 208; setting, 179–84, 201; as stationary, 5; and surveillance, 228–29; as workplace, 41. See also Martineau: Life in the SickRoom; sick visits sick visits, 25–28 passim, 170 –71, 208–9 Silent Comforter, The (Hopkins), 158, 161, 179, 183–85 Simcox, G. A., 221n, 222 Smiles, Samuel, 43, 171n, 218, 226, 233 Smith, Adam, 69–70 Smith, F. B., 151n Smith, Ginnie, 171–72n Smollet, Tobias, 135n Society for Promoting Christian Knowledge, 30, 172, 182 Society for the Diffusion of Useful Knowledge, 72 Society in America (Martineau), 227 Solace of an Invalid, The, 157–63 passim; implied readership of, 188; rhetoric of schooling in, 190; rhetoric of usefulness in, 37 South by West (Rose Kingsley), 146 “spermatorrhea,” 108

Spiritual Recreations in the Chamber of Affliction, 158 Squirrell, Elizabeth, 171, 209 Stephen, Mrs. Leslie. See Duckworth, Julia “Stephen and Rachel in the Sickroom” (Walker), 180 Sterne, Laurence, 135n Stevenson, Robert Louis, 1, 20, 22, 41, 143n, 159; “Alpine Diversions,” 150, 152, 153; “Apology for Idlers,” 43; beliefs about open air, 156–57; Child’s Garden of Verses, 44; correspondence with Symonds, 99; diagnosis and, 144n; in Davos, 144 –55; “Davos in Winter,” 150, 152; “Health and Mountains,” 146, 148, 150, 152, 156–57; Letters from Samoa, 41; “Ordered South,” 1, 61, 114, 152, 155, 249; “The Stimulation of the Alps,” 151, 153 “Stimulation of the Alps” (Stevenson), 151, 153 Stonhouse, James, 169 “Strolls with Invalid Children” (Craik), 30 – 31 Subaltern’s Sick Leave, A (Polson), 116 Sullivan, Alvin, 86 Sunny Life of an Invalid (Young), 36, 158, 182–83, 204 “Superannuated Man, The,” (Lamb), 75 Sussman, Herbert, 80, 88, 89, 97 Sylvia’s Lovers (Gaskell), 245 Symonds, John Addington, 20n, 98–112, 119, 159; academic career of, 101; aestheticism and, 105, 147, 153; Alps and, 141–55; anxiety about age, 249; beliefs about homosexuality, 100n22, 102–5, 155; childhood of, 98; confessional impulses of, 100 –101, 111; consumption and, 20, 98–99; “Davos in Winter,” 129n, 130, 145–53 passim; feelings about work, 46–47; identity as invalid, 99, 102–3, 143; Letters, 99, 103; Memoirs, 47, 65, 97–112, 143, 153, 154 –55; Our Life in the Swiss Highlands, 119, 129, 142, 149, 153; “Page of My Life, A” 141–43, 149, 150; Problem in Greek Ethics, A, 100n22; relationship to Stevenson, 99, 144; as sexual theorist, 107n; “What Cannot Be,” 102; “Win-

Index

ter Nights at Davos,” 20, 114, 150, 153, 249 Symonds, Margaret, 20n, 129, 142, 143n11, 149–50, 153 Sympathy of the Atonement, 188 symptom pyramid, 58–59 Taylor, Jenny Bourne, 45, 75, 108 Temple Bar, 115 Tennyson, Lord Alfred, 12, 76 Thackrah, Charles Turner, 75 Theory of Moral Sentiments (Smith), 60 –70 Think!, 176 Thomas, Gillian, 203 Thornton, A. H., 171n Thornton, John, 158 Tosh, John, 84 tourism, culture of, 7, 122–25 Townsend, Frederic, 44, 157n travel guides, 2, 62, 116–17, 122–23, 149; as form of invalid productivity, 41; images of invalid in, 16, 118; and periodicals, 18 travel industry, 16, 117, 172 treatment regimens, 4, 5, 6, 7. See also hydropathy; climatotherapy Tristram Shandy (Sterne), 135n Trollope, Anthony, 16 Trotter, Thomas, 74, 216 “Try the Bahamas” (Blake), 115, 122 Tuberculosis. See consumption Tucker, Herbert F., 252n Tuke, Daniel, 73, 104, 105n, 107, 167 Tuss, Alex, 80 Tyler, James Endell, 182 Typhoid Mary, 2n Up the Hill Difficult (Giles), 156, 185–86, 188–89, 197–98 valetudinarian, figure of, 12, 16, 49, 79 “Valetudinarian in Italy,” 113, 114 –15, 129, 130 Veblen, Thorstein, 65n Veith, Shirley, 1n, 21n View of the Nervous Temperament, A (Trotter), 74 “Voice from the Sick Room, A” (Tyler), 182 von Goethe, Ottilie, 222

291

“Voyage to Australia for Health, A,” 115, 125, 130 Vrettos, Athena, 3, 13, 20, 166n Wagner, Clinton, 147 Walker, Frederick, 180 Wanderings in Search of Health (Denison), 119, 121–29 passim, 140 Ward, A. B., 234, 243, 248; “Hospital Life,” 160, 210, 240 –41; “Invalid’s World, The,” 21, 31, 57–58, 202–3, 240 –43; on invalid as impostor, 31; invalid’s mind, 245; masculinity and, 44; and physicians, 57–58; on sickroom experience, 202–3; on visitors, 28 water cure. See hydropathy water spas, 35–36, 76, 82, 138. See also Malvern Watson, J. R., 246n2, 247, 248n Weak, Yet Strong (Chadwick), 166, 191–94 Wear, Andrew, 3n4, 33 “wear and tear” complaint, 41, 46, 80 –82, 252 “Wear and Tear of London Life, The” (Roose), 46, 75, 252 Webb, R. K., 200n1, 222, 225, 226 Weber, J. 148–49 Webster, Thomas, 13 “Week in Bed, A” (Whyte-Melville), 201, 203–9 passim, 234 –37, 243 Wesleyan Methodist Magazine, 188 Wessely, Simon, 224n Westminster Review, 120 What Is It To-Day?, 158, 188 Wheatley, Vera, 218, 220, 231n White, Hugh, 173–74, 188. See also Invalid’s Hymn Book Whitman, Walt, 100 Whyte-Melville, George, 201–9 passim, 234, 243; comparison to Wilkie Collins, 237; on invalid’s egotism, 212; on invalid’s posture, 236 Wilde, Oscar, 17 Williams, Anna, 48 Williams, Charles J. B., 125–26 Williams, Perry, 167 Wilson, James, 80, 90. See also “Dr. Wilson’s Water Cure Establishment” Winslow, Forbes, 105n

292

Index

Winter, Alison: on Martineau’s reputation, 222; on Martineau’s sickroom, 222, 225; on plausibility in medical history, 20; on popularity of Life in the SickRoom, 233n; medical profession’s response to Martineau, 220; on mesmerism, 28, 56, 59; on Unitarian and Evangelical pamphlets, 27n “Winter Nights at Davos” (Symonds), 20, 114, 150, 153, 249 Wives and Daughters (Gaskell), 245 Woman in White (Collins), 17, 31 women: and Christian sick role, 189; and fashion, 250; femininity, ideologies of, 6–7, 24 –25, 149, 157, 241; and public sphere, 48; as readers of commonplace books, 160; and social responsibilities, 24 –25; stereotypes of, 49–50, 229; and travel writing, 118; and work, 7, 25, 40, 47–50, 222. See also domestic ideology; “overwork”; sexuality: female; sickroom: as feminine

Woodham-Smith, Cecil, 25 Woolf, Virginia, 64, 244 Wordsworth, Mary, 218 work: advice manuals and, 48–49; categories of, 5; and conduct books, 48n; ethic, 32, 38–40, 60; Evangelical beliefs about, 43; intellectual, 7, 44 –45; for middle-class men, 43–48; selfscrutiny as, 185. See also industrialization; invalidism: and stigma of idleness; middle classes; “overwork” “Work” (Brown), 44 working class, 25, 42, 119n. See also middle classes: rhetorical strategies of Wright, Edgar, 246 “Yellow Wallpaper, The” (Gilman), 198–99 Yonge, Charlotte, 16–17, 45–46, 163 Young, C. Howard, 36, 158, 182–83, 204 Young Northern Traveler: Or, The Invalid Restored (Hefland), 74, 127