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Infectious feelings: disease, sympathy, and the nineteenth-century novel

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Infectious feelings: disease, sympathy, and the nineteenth-century novel

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INFECTIOUS FEELINGS:

DISEASE, SYMPATHY, AND THE NINETEENTH-CENTURY NOVEL

by

Darby Walters

A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(ENGLISH)

August 2022

Copyright 2022 Darby Walters

ii

To those who began this story with me but did not finish it:

H T Walters & Eleanor J. Wood

iii
Acknowledgements

This project is the result of many wonderful conversations with Hilary Schor, my
committee chair, who has instilled in me a love of narratology, close reading, and the magic of
Dickens and Gaskell during the nine years since I first took her class on narrative theory entitled
“Bleak House, or Why Do We Read Novels?’ My work would not be possible without her
rigorous and thoughtful feedback, incredible wealth of knowledge, and infectious passion for
narratology, as well as her friendship and support. Devin Griffiths has also been instrumental to
this project; he has encouraged and inspired me to combine my love for literature and medicine
and helped me to navigate the often-mystifying process of academic professionalization. Finally,
I am grateful to Elinor Accampo for bringing her deep knowledge of history to bear upon my
project and for her careful attention to my prose.
My writing group, which has over the years included Gerald Maa, Mike Bennet, Rebecca
Ehrhardt, Brianna Beehler, Michael P. Berlin, Anne Sullivan, Abigail Droge, and Shyam Vijay
Patel, has been an indispensable source of wisdom, inspiration, careful critique, laughter, and
camaraderie throughout this project. Whether at a Silverlake coffeeshop, rooftop bar, or zoom
session, they continued to believe in me and my work and remind me of my passion when it
momentarily waned. I hope that our group will continue through various iterations for many
more years to come.
I am also indebted to the many student scholars that I had the privilege of teaching in the
Thematic Option Honors College program, particularly those who helped me think about the
epistemology of the body in my course “Body Talk” and those who experienced a real global
pandemic even as we studied the social, cultural, linguistic, and biological meanings of disease

iv
in my course “Going Viral.” Their curiosity and passion helped me to find relevance in my work
and reminded me why it is important. This also applies to my many colleagues who have offered
thoughtful and attentive feedback at my presentations at INCS, NAVSA, The Victorians
Institute, VISAWUS, and the Dickens Project Winter Conference (especially including my two
faculty readers, Summer Star and Monique Morgan).
In addition to the incredible intellectual support of my colleagues, I am indebted to
several institutions for funding my research. The Social Sciences Research Council and the
Albert and Elaine Borchard Foundation were instrumental in allowing me to travel to Edinburgh
for the last year of my dissertation, where I was able to research at many of the same institutions
that had been attended by members of the Scottish Enlightenment. My time in Scotland not only
afforded me wonderful research opportunities, but also made the subject of my dissertation seem
“real” in a new way while giving me many wonderful memories. The University of Edinburgh
has been incredibly welcoming and supportive as well as intellectually stimulating even during a
pandemic. My thanks especially go to Sarah Chan and the Centre for Biomedicine, Self, and
Society. In addition, I must thank the Gold Family Foundation for allowing me to travel to
London for a summer to study at the Wellcome Library. The collections at the Wellcome Library
have formed the bulk of my primary source material on medicine and my project would not be
possible without my time there. And last, I must thank the USC Graduate School for funding a
2020 Summer Research and Writing Grant allowing me to attend the Yale Bioethics Summer
Institute and a Research Enhancement Fellowship allowing me valuable time to focus on my
writing.
Finally, and most importantly, I want to thank my family for their unfailing support
during the toughest of times. Each of them sacrificed in order to help me with my doctoral

v
career. Up until her death, my amuma (Basque for grandmother) quietly provided the extra
funding needed to secure an apartment in the skyrocketing rental market of Los Angeles. My
father, despite a long and terminal illness that required intensive caregiving, remained adamant
that I continue to travel and pursue my career. He insisted, even in his last days as I called him
from London, that the knowledge that I would become a Doctor of Philosophy was the most
important gift I could give him. And my mother, who continues to be an endless source of
support, has both literally and figuratively saved my life. While already caregiving for a husband
and mother, she spent two months by my bedside in the hospital suffering with me through
several blood clots, one removed rib, a collapsed lung, and four surgeries. She spent another ten
months helping me recover my ability to use my right arm, taper off a debilitating amount of
medication, and remember how to think and write again. We have laughed together, cried
together, celebrated together, and mourned together. Thank you.

vi

TABLE OF CONTENTS
Dedication…………………….…………………………………………………………………ii
Acknowledgments……………...………………………………………………………………iii
Abstract………………………...………………………………………………………………vii
Introduction: Sympathetic Connections……...……………………………………………………1
Teleology vs. Etiology………..…………………………………………………….3
Sympathy………………………………………………………………………….10
Medical Developments……………………………………………………………14
Epistemic Virtues………………………………………………………………….17
Chapter 1: From Patients to Wives in Sense and Sensibility………...…………………………..27
Austen’s Sympathetic Style………………………………...………………………..31
The Pathology of Sympathy………………………………………………………….35
Sympathy and Synecdoche……………..…………….………………………………39
Treatment for the Nervous System…..……………….………………………………45

Chapter 2: The Shape of Disease in The Last Man…...………………………………………….51
Sympathy: The Part and the Whole…………...……………………………………..53
Global Sympathies………………………..………………………………………….59
Bodily Sympathies………………...…………………………………………………63
Sympathy in Time and Space………..………………………………………………68
Chapter 3: A “Natural Exhalation” of Rumors in Deerbrook……………………………………75
The Changing State of Medicine……………………………………………………..76
Gossip and the Nervous System………..……………………………………………82
A Healthy Crisis……………………………………………………………………...87
Hope’s Epistemic Virtues……………………………………………………………89
Narrating the Present…………...…………………………………………………….93
Miasma, Poverty, and Squalor…………….…………………………………………97
Chapter 4: “The Present was Everything” in Mary Barton…………………….……..………..101
Embodied Sympathies……………………………………………………………...104
The Topography of Miasma…...……………...……………………………………114
An Untraceable Cause of Woe....………..…………………………………………119
Temporal Virtues….……...…………………………………………...……………125
Looking Forward..…...……………………………………………………………..130
Bibliography…..………………………………………………………………………………..135

vii
Abstract
What is infection without germs? Until the latter decades of the nineteenth century, there
were no germs. There were, of course, many diseases, but the bacteria and viruses that now
constitute the majority of germ theory were not yet a part of the medical imagination. My
dissertation examines the shifting medical and popular understandings of disease in the British
nineteenth century from Romantic interpretations of diseases as products of nervous disorder
through the ascendancy of miasma theory, which attributed disease to mysterious qualities of
insalubrious air. While scholars generally agree that the medical discourse changed during the
early nineteenth century from one of nervous sympathies to one of miasma and filth, few have
examined how these two discourses combined and complimented each other. “Infectious
Feelings” argues that the confluence of sympathy and miasma not only produced a unique
medical model of epidemic disease but also introduced new questions about the relationship
between time and space before being replaced with a new set of questions engendered by germ
theory. Because the novel had similar investments in mimetic representation as medical treatises
and case studies but also possessed a broader set of narrative techniques for investigating time,
space, and causality, the novel became a site in which to explore the questions that medicine
posed. Rooted in an interdisciplinary methodology, “Infectious Feelings” draws on narrative
theory, medical humanities, and cultural history, as well as extensive archival research, to
understand feelings of illness and disease as specified and understood explicitly during the
nineteenth century in terms of nervous disorder and sympathy. It argues that such feelings
influence the form of medical tracts and novels alike, and that they both appropriate and inform
the medical imagination of time and space.

viii
Prior to germ theory so little was known about the etiology of disease that Great Britain’s
premier medical journal, The Lancet, complained: “the rise of epidemics is so involved in
obscurity, so lost amidst the invisible agents of nature, so much beyond the ken of our
comprehension, [that to] differ in the circumstances of time, place, and peculiarity, would seem
to be the only point in which these visitations agree” (640). The Lancet knew that understanding
the time and place of disease was an important epistemological step in understanding disease
itself, and furthermore, it recognized that it did not yet envision time and space in a way that
could completely unlock the mysteries of epidemics. The Lancet’s frustration was due to
disputed medical conceptions of time and space of disease that gained traction in the late
Romantic and early Victorian period. The most important description of time and space, what
Mikhail Bakhtin has called a “chronotope,” centered on the relationship between nervous
sympathy, a conduit that transferred both feelings and sensations from organ to organ and body
to body, and the etiology of infectious disease. Nervous sympathy provided some understanding
of how disease, infectious and otherwise, traveled through space both within the viscera of the
human body and in the environment at large. A conduit for emotion, energy, sickness, and
health, sympathy was a key component of Romantic organicism that connected disparate parts
into a larger whole. Sympathy was imagined as traveling instantaneously, however, offering
readers of disease little information about the origins of the disease or its progress through the
body on either a human or a cultural scale. As Dr. Sandwith of London laments in 1835: “Great
obscurity hangs over the pathology of … disease, simply from not discriminating between the
primary and secondary events in the order of causation” (34). A timeline of disease could not be
created because no one knew which events caused others. The presence of sympathetic models
and the lack of etiological ones caused disease to be more often imagined in terms of spatial

ix
rather than chronological vectors. My project not only explores how this chronotope operated in
medicine but also how fictional writers engaged it in order to create a medico-moral philosophy
that applied to a variety of medical and non-medical narratives.

1
Introduction:
Sympathetic Connections
“What connexion can there be, between the place in Lincolnshire, the house in town, the
Mercury in powder, and the wherabout of Jo the outlaw with the broom, who had that distant ray
of light upon him when he swept the churchyard step? What connexion can there have been
between many people in the innumerable histories of this world, who, from opposite sides of
great gulfs, have, nevertheless, been very curiously brought together!”
-- Charles Dickens, Bleak House (1852-3)
“What connexion can there be?” is not only one of the central questions of Bleak House,
whose narrator answers it via an illegitimate sexual liaison, a murder plot, several deaths, and a
disfiguring epidemic of smallpox, but also, this dissertation argues, a question that united the
field of medicine with the field of literature in Britain during the nineteenth century. Both
disciplines sought to understand the connections between bodies that shared or contributed to
one another’s suffering despite being separated by “great gulfs” of a spatial, temporal, or
economic nature. In Bleak House, Dickens combines medical content with fictional form when
Jo, the impoverished orphan who lives in the “tumbling tenements” of Tom-All-Alone’s that
“have bred a crowd of foul existence … fetching and carrying fever,” contracts smallpox. He
wanders out of London and eventually ends up in St. Albans at Bleak House where he infects
Esther Summerson who briefly takes him in out of sympathy (197). Jo and Esther are “very
curiously brought together” through their bodily suffering, which through unspecified
mechanisms of infection, transcends class and rank as well as geographic boundaries between
London and its surrounding villages.
1
Dickens’s novel reflects the fact that, for both author and

1
Dickens later makes the connecting power of disease even more explicit as he talks about Tom-
All-Alone’s: “There is not a drop of Tom’s corrupted blood but propagates infection and

2
doctor, disease dramatized with corporeal materiality the network of sympathies and antipathies,
transactions and interactions, that connect people through time and space. It brings to life, and
sometimes to death, the otherwise abstract relations between, say, the inhumane economic and
hygienic conditions of a London slum and the marriage prospects of a young smallpox-scarred
orphan girl in Hertfordshire.
Yet, even as nineteenth-century narratives embraced disease as a literal and metaphorical
form of interconnection, British medicine struggled to elaborate how that connection actually
worked. “What connexion can there be?” doctors might well have asked, between “the heat of
skin, accelerated pulse, diminished secretions, and the like” that resulted from disease and the
“heat, cold,” “irritation of different parts,” “passions of the mind,” “putrid vapors,” “marsh
miasmata,” “human and animal contagion,” and “perhaps, many other poisons, the source and
nature of which are unknown to us” that caused disease (Clutterbuck xii, 105).
2
The mechanisms
that transformed the causes of disease into the symptoms that plagued the suffering body
remained largely and frustratingly unknown (Bynum 17). Dickens’ depiction of smallpox as
deriving from a confusing jumble of sources, including the “pestilential gas” emitting from the
miasmatic refuse of Tom-All-Alone’s and the “peculiar smell” that denotes Jo’s personal
contagion, is not a literary device but rather an accurate depiction of the multiple, over-

contagion somewhere. It shall pollute, this very night, the choice stream… of a Norman house,
and his Grace shall not be able to say Nay to the infamous alliance. There is not an atom of
Tom’s slime, not a cubic inch of any pestilential gas in which he lives, not one obscenity or
degradation about him, not an ignorance, not a wickedness, not a brutality of his committing, but
shall work its retribution, through every order of society, up to the proudest of the proud, and to
the highest of the high” (553).

2
See Henry Clutterbuck’s treatise: An Inquiry into the Seat and Nature of Fever; as Deducible
from the Phenomena, Causes, and Consequences of the Disease, the Effects of Remedies, and the
Appearances on Dissection. (2
nd
ed., 1825).

3
determined, and yet deeply uncertain, etiological understandings of disease that existed in the
medical field (553, 380).
On the surface, these two iterations of “What connexion can there be?” may appear quite
different. The former version appears primarily occupied with the connections between bodies,
diseased or otherwise, across geographic distances and social milieus, while the latter version
appears to focus on the connections between cause and effect that form a chronology of disease.
Yet, the following pages argue that these two iterations are deeply imbricated, that the answers to
these questions depend on interdependent epistemologies, and that, moreover, both medical and
literary approaches to these questions form a symbiotic relationship because they rely
simultaneously on narrative technique and scientific models that draw from both genres of
writing. I do not propose that either the nineteenth-century novel or its contemporary medical
texts presume to answer definitively the question that Dickens proposes mid-century, but I do
argue that they collaborate to form a historically specific and evolving approach to such
questions that informs the medical imagination of the suffering body across both genres. This
dissertation focuses on the medical, philosophical, and literary circumstances of the early
nineteenth century that give context to Dicken’s question and it analyzes the sympathetic
relations that connect forms of organic life across time and space.
Teleology Versus Etiology
Answering a question like “What connexion can there be?” involves a series of
epistemological decisions. In the context of Esther Summerson and little Jo, one might answer
that the connection may be explained as the consequence of Jo’s poverty, which contributes to
his contracting the disease in the first place, the constant exhortation by the constabulary that Jo
must “move on,” which causes him to roam the countryside, and Esther’s and Mr. Jarndyce’s

4
kind sympathy, which puts them in close contact with the sick boy. However, one might also
explain Jo and Esther’s connection as the cause of Esther’s reunion with her mother as she
recovers from her illness, the disfigurement of Esther’s face, and Allan Woodcourt’s interest in
making Jo comfortable during his dying hours. In other words, one may explain the connection
between Jo and Esther in terms of etiology (the set of events that cause a phenomenon) or
teleology (the set of events that result from a phenomenon).
3

While many scholars have argued that the realist novel is structured by narrative causes,
or a system of etiology, Jesse Molesworth argues instead that “traditional narrative ultimately has
two tasks: to describe events interestingly and to describe events coherently or teleologically,
neither of which are especially useful to a rational understanding of causation” (6). In opposition
to the conventional understanding of the novel, promulgated notably by Ian Watt, that the novel
stems from the Enlightenment call for truth and reality, Molesworth does not “believe that the
novel, even at its most mimetic, is responding or contributing to a ‘hunger for actuality’” because
every detail of a narrative by virtue of its inherent premeditation is carefully chosen for its
meaning: “the stronger the narrative – the more carefully conceived, the more closely attentive –
the stronger its premonitory or prophetic character” and the weaker its realistic or rational traits
(2, 7). As Chekhov’s famous gun illustrates, detail must always mean something in order for the
narrative to cohere.
4
Thus, while novels may appear to follow a chain of cause and effect, that

3
Although I propose etiology and teleology as a dichotomy, it is useful to note that they are most
frequently used in very different disciplines. Etiology is primarily a medical term used to refer to
the search for the origin of disease while teleology arises primarily from theology and
philosophy. Bringing these terms together is one way this project unites epistemological
concerns that transcend disciplinary boundaries.

4
“If in the first act you have hang a pistol on the wall, then in the last act it must be shot off.
Otherwise you do not hang it there” (Simmons, 190). Molesworth’s reasoning may appear in
contradiction to Barthes claim in “The Reality Effect,” The Rustle of Language that realism
depends upon those “useless details” which do not serve any function. Barthes’ focus is on the

5
chain is always constructed retroactively and is disconnected from a “rational understanding of
causation,” therefore disrupting the mimesis of the narrative. In my earlier example, we as
readers must always remember that Dickens writes Bleak House in order to get to certain end
points, Mr. Tulkinghorn’s murder, Lady Dedlock’s death, and Esther’s marriage, and therefore
teleology always underscores the connection between people and events.
By divorcing the novel from Enlightenment thinking, Molesworth provides an important
counterpoint to the argument of many scholars who have connected medicine and the novel
precisely through their assumed investment in realism and shared techniques of conveying truth
that stem from the Enlightenment’s fractious twins: empiricism and rationalism. Lawrence
Rothfield suggests that the nineteenth-century novel espouses the techniques of clinical medicine
because such techniques offered “an ideology of professional exactitude, an ideology that was
extremely useful to novelists when new conditions of the marketplace enabled writers to picture
themselves as self-sufficient professionals” (xiv). Speaking of the shared ideals of the novel and
the case history, Meegan Kennedy expands on Rothfield’s argument by writing: “clinical
methods of observation and representation offered writers some useful and powerful strategies,
conveying a sense of rigorous scrutiny, careful description and narration, and professional

details of description, however, which differ substantially from the details of plot that
Molesworth discusses (142).

6
knowledge” (Kennedy 1-2).
5
Such strategies, scholars argue, contributed to the mimesis of many
nineteenth-century novels.
6

While both case histories and novels aspired to realism, however, neither genre can be
fully “real;” total mimesis would require absolute objectivity, omniscience, and perhaps most
importantly and impossibly, total adherence between signified and signifier. That is, even if
unlike Molesworth, we grant that doctors and authors may hunger for actuality, we must
acknowledge, as they themselves often did, that they cannot achieve it through narrative form.
To identify any novel as a “realist novel” is therefore open to contestation, and the almost
unlimited number of definitions of realism with each new scholarly argument is a testament to
that fact. For some, like Watt, the genre of the novel is by definition realist, while for others, like
Caroline Levine, realism is a more precise skeptical method associated with the mid-nineteenth
century.
7
My own definition of realism aligns more with the former because I am interested in
mimesis in the broadest sense. It may justly be said that none of the novels I discuss can be read

5
See also Jason Tougaw’s Strange Cases: “Writers in both genres experimented with techniques
that could give narrative shape to identity, and over the course of two centuries, the genres
influenced each other by exchanging both subject matter and methods. In novels, the doctor-
patient relationship becomes an implicit model for the relationship between a reader and a novel
(or its characters), and the novel offers writers of case histories a set of conventions that enable
them to tell the stories of suffering patients” (2).

6
Kennedy has noted that case histories often fail to live up to their mimetic ideals. She argues
that novelistic techniques “help normalize or naturalize cases that otherwise disturb the case
history – the narrative site of medical professionalism – particularly when these cases call
attention to the boundedness of medical knowledge and practice” even as the methodologies of
the case history help to bolster the authority of the novel’s author or narrator (Kennedy 17).

7
Levine’s definition is more aligned with the Victorians themselves, however. She notes: “the
term ‘realism’ did not apply to all mimetic endeavors in the nineteenth century – or even to all
notions of truth in representation. Victorian uses of the world ‘realism’ referred to a critical
aesthetic project that midcentury thinkers worked to formulate and define explicitly” (11). While
this is an astute point, I risk anachronism to call attention to a desire to write what is “real” that
precedes this mid-nineteenth century skeptical turn.

7
solely as “realist” novels; yet each novel displays an impulse to adhere to a rather confusing
cluster of terms including “real,” “accurate,” “logical,” and “true,” even as they also engage with
generic tropes of sentiment, fantasy, and romance. At the risk of tautology, I define these novels
and their relation to realism by this impulse, acknowledging, to quote George Levine, that “the
isolation of a genre to be called the realistic novel entails a circular inductive method: the
abstraction from novels we already presume to be realistic of the qualities that make them so”
(11). I also follow Levine in thinking about realism “as a process, response to the changing
nature of reality as the culture understood it, and evoking with each question another question to
be questioned.” My argument deals less with what realism is writ large but rather with how
realism interacts with medical epistemologies existing in the first half of the nineteenth century.
My interest is in how certain novels produce the appearance, however precarious, of a mimetic
relationship with external referents by using such epistemologies to circumvent the paradox of
representing causal relationships in a form that is inevitably teleological.
One important aspect of Molesworth’s argument which this dissertation expands upon is
the disruption of Watt’s claim that the novel can be identified by “a causal connection operating
through time” (22). Each of the novels I discuss cast doubt on causal chronologies even as they
aspire to a sense of the real, which has conventionally been assumed to depend on causality.
Molesworth’s formal argument that the novel is always implicitly grounded in teleology even as
it strives for the appearance of an etiological rationale provides an important connection with
medical narratives during the first half of the nineteenth century, which were struggling with
their own contradictions between teleological and etiological approaches for historical reasons.
While the novel can never completely escape teleology due to its narrative form, early
nineteenth-century medicine could not escape it due to its understanding of disease and the limits

8
of medical knowledge and technologies. As W. F. Bynum has noted, medicine at the beginning
of the century could not be classified etiologically because doctors were unsure of the various
causes of disease (17). Although various hypotheses were hotly debated throughout the century,
it was not until the acceptance of germ theory in its last decades that etiological classifications
became possible and widely embraced. Rather, doctors most often approached disease in terms
of symptomology, following the well-known French doctor P. J. G. Cabanis’s empiricist
assertion that medical expertise comes from experience and consists of facts rather than primary
causes (20, 29). This approach was accepted as much from necessity as from ideology as doctors
reflected with exasperation on their own lack of etiological knowledge. The Lancet writes of
cholera in 1832: “What this cause is we know not, and we know that no one else comprehends it.
We cannot speculate upon it. We believe it, in short, to be at present beyond the limits of human
comprehension” (“Proofs” 62). Like novelists invested in mimesis, doctors desired to create a
rational system of cause and effect. Yet, only the effects of disease, their signs and
symptomologies, were available to the senses. Thus, while medical rhetoric was useful in lending
empirical authority to the novel, it was less helpful in providing an etiological model.
8

Because neither genre could comprehensively provide the etiological explanations they
sought-- the one to better mimic reality, the other to better explain it -- they had to find other
strategies for conveying truth. One strategy in addition to empiricism was to envision the world
as connected through a series of spatial relationships instead of the chronological relationships
that proved so problematic. One of the main arguments of this dissertation is that during the first
half of the nineteenth century authors and doctors shared what Mikhail Bakhtin has called a
“chronotope,” or a communal vision of time and space, to work through the epistemological

8
Empiricism does not ask “why?”. As theory became discredited, so too did the rationalist
techniques to find causation even if the desire to know such causes remained.

9
problems they faced. For Bakhtin, the chronotope is the special provenance of literature and art
and “has intrinsic generic significance” (84-5). I see the medical treatise and the novel as
engaged in, to borrow yet another of Bakhtin’s terms, a dialectic relationship that shares a
chronotope across genres in order to work through their mutual problems of narrative. As
Bakhtin notes, the chronotope functions:
as the primary means for materializing time in space, emerg[ing] as a center for
concretizing representation, as a force giving body to the entire novel. All the novel’s
abstract elements – philosophy and social generalizations, ideas, analyses of cause and
effect – gravitate toward the chronotope and through it take flesh and blood, permitting
the imaging power of art to do its work. (250)
In the case of the novel and the medical treatise, their shared chronotope, or the way they
envision the relationship between time and space provides an uneasy backdrop for rendering the
“flesh and blood” of the diseased body in narrative form. Moreover, this particular chronotope
bypasses the problems involved with analyzing cause and effect, those problems that arise from
the inability to rely fully on etiological principles, by foregrounding spatial relationships even
within the medium of narrative that, by its nature, is a function of chronology.
9
This paradoxical
strategy creates its own problems, of course, which each of the authors I discuss approaches in a
different manner. Yet, one concept unites this project’s medical and fictional narratives and
provides a versatile anchor for their shared visions of time and space: that concept is sympathy.
Sympathy
In a sense, sympathy was the answer to the question “What connexion can there be?” not
only for Dickens at mid-century but also for many authors and doctors in the decades that

9
Bakhtin writes, “In literature the primary category in the chronotope is time” (85).

10
preceded him. Sympathy was the force that often did the work of connecting people and events
in narratives that did not or could not connect them causally. The concept of sympathy has a long
and interdisciplinary history that is most frequently traced back to David Hume (1711-1776) and
Adam Smith (1723-1790) during the Scottish Enlightenment. According to Hume’s A Treatise of
Human Nature (1739), sympathy is “that propensity we have … to receive by communication
[others’] inclinations and sentiments however different from or even contrary to our own” (490).
This definition provided the groundwork for a turn towards fellow-feeling as a fundamental
moral impetus that dictated social interaction and contextualized cultural narratives including the
novel. Sympathy was “the great cement of human society,” and it allowed a vision of community
as greater than the sum of its individuals (Kames 19).
10

The social sympathy discussed by the two philosophers existed on a continuum with the
physiological sympathy of the nervous system that was promoted most extensively by Robert
Whytt and Alexander Monro, confidants of Hume and Smith and influential physicians at the
Edinburgh Medical School (Lawrence 26).
11
For Whytt and other early Edinburgh physicians,
sympathy communicated feelings via the nervous system from one part of the body to another.
This internal operation of sympathy worked via the same principles as the sympathy between
individuals discussed by Smith and Hume. Whytt writes in 1765 that “although in these cases of

10
Henry Kames’ Essays on the Principles of Morality and Natural Religion was first published
in 1779.

11
Rae Greiner has posited a difference between the sympathy of Hume and the sympathy of
Smith, writing: “Smith’s sympathizer abstracts feeling, routing it through cognition, while Hume
allows for sensation to be transmitted both directly and unconsciously from one person to the
next – [this distinction] has elicited a kind of continental drift in a criticism understandably
enamored with Humean tropes of vibration, contagion, and ‘force’” (5). While Greiner’s
distinction leads to one cogent reading of realism, it also elides the embodied nature of sympathy
for both Hume and Smith who envisioned sympathy in terms of the nervous system. Christopher
Lawrence writes: “Sympathy, for Smith as for Hume, is a feeling. As such it is transmitted by the
nervous system and, therefore, depends on the latter’s condition” (32).

11
[social sympathy] the changes produced in the body are owing to the passions of the mind; yet
the mind is only affected through the intervention of the optic and auditory nerves, they seem
proper enough instances of the general sympathy that extends through the whole nervous
system” (11). Disease, including but not limited to those diseases that we now view as
contagious, spread through both communities and bodies via sympathy.
12
Individuals, usually of
the higher classes, who possessed greater “sensibility” were affected by sympathy more readily
and were thus more receptive to the feelings and sensations, as well as pathologies, of their own
bodies and those of others.
Sympathy remained an important medical epistemology until the middle of the nineteenth
century and it was a common lecture topic in the hospitals of London. Almost sixty years after
Whytt describes the nature of sympathy, Mr. Abernethy, a surgeon at St. Bartholomew’s
Hospital in London, similarly explains to students in 1824 how, through the sympathetic nervous
system, the entire constitution as a whole could be affected by a single diseased organ or part:
As local diseases become the source of constitutional derangements, so, on the
other hand, local disease, is often the result of a general disturbance of the
system; and these reciprocal actions are produced through the medium of what has
been called an universal sympathy. If the local disease which acts as an irritation
to the general system be extensive, or be seated in an important part, the
sanguiferous and secerning functions are disordered … There is a great agitation,
restlessness, irritability, and so on; the nervous system is in a state of excitement, and this

12
This is not to say that sympathy was the only factor that was believed to contribute to disease
(others included poisons, environmental conditions, and lifestyle), but it was an important
element in explaining the particular course of disease in a given individual.

12
very much influences the functions of all the organs of the body. (“Surgical
Lectures…Abernethy” 97)
The state of the part mirrored the whole and vice versa even when the exact sequence of
causation was not known. As Mr. Guthrie instructs at Westminster Infirmary during the same
year, to be a good medical worker was to be able to identify the correspondence between body
part and individual:
There is no part of the body which can be considered but as a part of the whole; each part
is a small system within a large system, the one acting and again reacting on the other;
subject to the same general laws, and benefited by the same general treatment… Is the
[broken] bone like a piece of timber, unconnected with a living structure? Then a
carpenter could replace it as well as a surgeon. But it is a part of the living body and
reacts upon the system, and requires constitutional as well as local treatment. (“Mr.
Guthrie” 17)
For Mr. Guthrie, sympathy is what divided living from non-living structures, and an
understanding of sympathy is what made doctors good practitioners of medicine, which is here
implied to be, unlike the mechanical practices of carpentry, both science and art. As Christopher
Lawrence has noted, sympathies of the nervous system “were used interchangeably as definitions
of the properties of the nervous system or of the soul” (25). In other words, sympathy connected
biological and spiritual registers, creating an overdetermined system of behavior.
The idea that sympathy via the nervous system was responsible for the transmission of
sensation and sentiment between internal organs within the body and between individuals within
the community is a core tenet of this dissertation for two reasons. First, this dual transmission
means that sympathy was an important term for medical practitioners, moral philosophers, and

13
fiction writers alike. A long and rich conversation about sympathy arose during the latter half of
the eighteenth century across the disciplines. Because sympathy connected the empirically
observable and locatable viscera of the nerves and brain to metaphysical conceptualizations of
morality and soul, it was an organizing principle that transcended the boundaries between
Enlightenment thinking, Romanticism, and mid-nineteenth-century objectivity and realism.
13

Second, because the same sympathetic influences affected the internal workings of the body and
the external behavior of an individual within the community, thinkers across the disciplines often
described physical and social bodies as analogous. As the medical and philosophical ideas of the
Scottish Enlightenment gained traction throughout Great Britain and beyond, so too did the
analogy between body and community.
Sympathy provided a system of organic relations and a system of disease that did not
depend on etiological principles. Traveling through the interstices of the body and jumping from
nervous system to nervous system, sympathy was a profoundly spatial phenomenon. Because it
was an instantaneous process, or at least nearly so, it could not be easily described
chronologically. Rather, sympathy was a reciprocal phenomenon; the state of the part affected
the whole even as the whole affected the part.
14
Attempting to distinguish between the cause and

13
For a history of how sympathy extends from the Scottish Enlightenment through Romaticism,
see Walter Jackson Bates’ “The Sympathetic Imagination in Eighteenth-Century English
Criticism,” ELH, vol. 12 no 2, 1945, 144-164.

14
Sir Astley Cooper lectures in 1823: “Irritation is either local or general, and its effects are
communicated from one part to another, through the medium of the nerves, so that the heart,
brain, and stomach, almost immediately after an injury has been sustained, even in the remotest
parts of the body, will have their functions more or less disturbed, in proportion to the extent of
the injury, and the importance of the part injured. There exist, among all parts of the body,
intimate relations, all corresponding with each other, and carrying on a reciprocal intercourse of
action. The wonderful and beautiful harmony produced by these concurrent phenomena, is called
Sympathy; its real nature is yet unknown, but we are acquainted with many of its effects”
(“Surgical Lectures…Cooper” 37, emphasis mine).

14
effect of a state of being was not only impossible but also nonsensical according to a sympathetic
model. This is not to say that doctors never attempted to ascribe causes to phenomena, but rather
that they often turned to sympathy to explain why they often failed to do so successfully; the
problem was not a lack of data or logic but rather a function of sympathy’s instantaneous
reciprocity. Within the sympathetic nervous system, everything was both cause and effect. While
doctors acknowledged that there were certain external poisons that contributed to disease, such
causes were not central to a model that focused more on the intercommunication of parts.
Sympathy allowed doctors to have a working knowledge of the body, mind, and disease that did
not depend upon causation.
15

Medical Developments
Sympathy was the hallmark of a Bakhtinian chronotope of disease that doctors and
authors shared during the early nineteenth century. It validated a teleological method of knowing
the world across disciplines. Doctors could focus on the symptoms of disease without worrying
too much about its causes, while authors could appropriate an empiricist system of sensation and
sentiment that was based on medical and moral authority and therefore conveyed a sense of the
real but which was not dependent on etiological principles that were problematic for a
premeditated form such as the novel.
This chronotope arises at the nexus of several medical developments that took place
approximately between 1800 and 1850, including the well-documented arrival of what Foucault
has termed the “birth of the clinic.” British doctors transitioned to clinical medicine later than

15
Other scholars, notably Jason Tougaw and Cynthia J. Davis, have written thoughtfully about
sympathy in medicine but in a very different context. They focus on the role of doctors during
the nineteenth century, who must “balance precariously on the line between… ‘science’ and
‘sympathy’” in order to appropriately treat their patients (Davis 21).

15
their colleagues in France, but as Kennedy notes, “effects ripple[ed] out from Paris: the rise of
hospital medicine; the burgeoning spirit of research bringing new medical treatments,
instruments, and statistics; the formalization of medical training; and… the birth of the science of
pathology based on the cold gaze of the autopsy” (55-6). These new medical practices were
neither simultaneous nor uniform; they spread to Edinburgh and London slowly and fitfully and
sometimes took decades to become fully realized in rural areas. Yet, clinical medicine as an
epistemology was adopted much earlier than it was as a practice. It “appears promptly in medical
texts, due to the newsworthiness of the new methods, the evangelism of the early adopters, and
the reformist influence of the Lancet” and was most quickly adopted by hospital physicians
(Kennedy 56).
16

One of the most important changes implemented by clinical medicine was a radical
revisualization of time and space. As Foucault puts it, diseases of pre-clinical medicine existed in
“only one plane and one moment” (6). Before 1800, disease was a phenomenon interpretable
only through a system of nosology. It was divorced from the spaces of the body and from
biological chronologies.
17
Clinical medicine, on the other hand, viewed disease within biological
and social spaces and within strict sequences of cause and effect: “it is caught up in an organic

16
Miriam Bailin argues that scientific medicine “had relatively little impact upon the
representation of illness and recovery in early and mid-Victorian fiction” (3). Yet, even if clinical
and scientific practices did not play a large role in the methodologies of the sick room, just as
they often did not play a large role in the rural medical practices of much of Great Britain, they
still influenced the form of the novel by influencing the epistemological assumptions that
underly representations of time and space.

17
“In [pre-clinical] pathology, time plays a limited role. It is admitted that a disease may last,
and that its various episodes may appear in turn…But this numerically fixed duration is part of
the essential structure of disease, just as chronic catarrh becomes, after a period of time, phthisic
fever. There is not process of evolution in which duration introduces new events of itself and at
its own insistence; time is integrated as a nosological constant, not as an organic variable. The
time of the body does not affect and still less determines, the time of the disease” (Foucault 12).

16
web in which the structures are spatial, the determinations causal, the phenomena anatomical and
physiological” (189). Broadly speaking, Foucault’s history of clinical medicine accurately
describes the transitions in medicine between 1800 and 1850. Disease prior to the nineteenth
century occupied a very different space and time than it did fifty years later. However, what
Foucault elides, at least partially because of his focus on France, is the halting and uneven nature
of this transformation in Great Britain and the role sympathy played during the transition.
Sympathy, a model of disease in place by the turn of the century, was conducive to
thinking about disease in terms of spatial and social relations and doctors adopted the idea of
disease as a phenomenon of biological and geographical spaces early on. If disease was locatable
in such spaces, then doctors should be able to identify them by strict observation, an idea that
appealed to a discipline that was already countering the dangers of abstract theory with an
increasing emphasis on empiricism. The importance of observation for early nineteenth-century
doctors cannot be overstated. Dr. Andrew Wilson’s comments on theory in his treatise, Practical
Observations on the Action of Morbid Sympathies (1818), are indicative of general opinion: “the
time is mis-spent which is employed in explaining the doctrine of disease on a preconceived
theory, or in trying to form a theory for the purpose of explaining the nature of a disease, in place
of observing impartially the phenomena of its progress” (37). Impartial observation was an
important precursor to the development of clinical medicine.
However, sympathy was not conducive to thinking about disease in terms of time, and the
temporal chain linking the cause of disease to its symptoms and outcomes, as well as the full
expression of clinical medicine, would wait to be fully realized until the advent of germ theory.
Therefore, the first half of the nineteenth century was a hybrid period that is often glossed over in
histories of medicine. Spanning the reign of two monarchs, shifting from early century contagion

17
debates to the wide acceptance of miasma theory, and witnessing the rapid growth of
industrialization, it is a messy period but one that is nevertheless united, this dissertation argues,
by the proliferation of a sympathetic chronotope during clinical medicine’s nascence. For the
purposes of this project, I begin my analysis with the publication of Jane Austen’s Sense and
Sensibility in 1811 and end it with Dickens query of “What connexion can there be?” in Bleak
House in 1852, but these literary events are only convenient placeholders for larger and more
indefinite movements in both fiction and medicine. The project could similarly be demarcated by
the Apothecaries Act of 1815 (which began the regulation of medicine in Great Britain and
required lecture attendance and clinical work for aspiring apothecaries) and the publication in
1849 of John Snow’s On the Mode of Communication of Cholera (which documented a
successful etiological investigation of cholera that presaged later experimental medicine).
18

Without, then, becoming too concerned with delimiting the exact dates of a phenomenon as
complex as the medical epistemology of authors and doctors across Great Britain, I suggest that
the first half of the nineteenth century emphasized the spatial and social relationships within and
between bodies, while minimizing the role of cause and effect delineated by distinct
chronologies.
Epistemic Virtues
The chronotope associated with sympathy not only promoted a certain kind of
epistemology but also linked that epistemology with a moral code, creating what Lorraine
Daston and Peter Galison have termed an “epistemic virtue.” An epistemic virtue functions “in

18
John Snow’s work was frequently disregarded by the medical community, but its methodology
differed significantly from previous investigations of disease. It rejected “the general notion of
‘filth disease’ in favor of a series of specific noninterchangeable infectious diseases, spread
through a variety of means, and requiring separate study,” and at least retrospectively provided
an important precursor to germ theory (Bynum 81).

18
the service of the True, not just the Good” (53). It delimits not simply how one sees the world,
but how one should see the world. The doctors and authors of the early nineteenth century
created a moral code for conceptualizing time and space that was powered by the forces of
sympathy. Good doctors, in both the effective and moral sense, focused on observing the details
of the present moment; they did not try to fit those details into past theoretical models or to
speculate about their relation to future phenomena. The epistemological virtues of sympathy in
the medical sense were inseparable from the more traditional virtues of sympathy in the
philosophical sense. Moral judgements about how and when to sympathize with others depended
upon an understanding of the pathologized body and how it relates to time and space, and these
judgements extend far outside the medical realm. The novelists in the following chapters
consolidate the virtues of the True and the Good, building narratives that adopt sympathetic
chronotopes on a formal level while addressing disease and sympathy within the plot.
I argue that a text does not necessarily have to possess the thematics of disease and
medicine in order to espouse the formal conventions of medical narrative. Rather, as Rothfield
notes: “One should be able to find some of the same techniques at work in other realistic novels
where doctors and patients do not appear as such or appear only at the margins of the story
(xvii). My focus, like Rothfield’s, is on the “practical cognitive rules” and values that shape the
form of literature and medicine during the early nineteenth century (xiii). The fact that each of
the novels I address also explicitly engages with disease helps to strengthen my argumentation
but is not strictly necessary. The chronotope of sympathy that I describe is present even in those
portions of the novels that are not explicitly medical and may be identified in novels without
medical content.
19
On a similar note, because sympathy was a cultural episteme that transcended

19
It might be more of a challenge to find books during this time period that do not engage with
disease since the sick body was one of the primary concerns of nineteenth century literature.

19
disciplinary boundaries, to think about sympathy did not necessarily mean to think about
medicine even though it was perhaps most elaborately theorized within the medical field.
All the authors in this dissertation were part of well-educated, intellectual circles and had
a working knowledge, albeit second-hand, of medicine. Although reconstituting the exact extent
of their medical knowledge is difficult, biographical anecdotes suggest that each exhibited at
least an interest in the medicine that influences their novels. Jane Austen, for example, wrote to
her sister, Cassandra, about “a very pleasant day” in which her companions “alternately read Dr.
Jenner’s pamphlet on the cow pox” (64 Le Faye). Mary Shelley grew up in close proximity to
her father’s good friend and eminent anatomist, Sir Anthony Carlisle.
20
Harriet Martineau
experienced medicine from the patient’s point of view throughout her life as documented in her
memoir, Life in the Sick Room (1844). And Elizabeth Gaskell relied on Combe’s Principles of
Physiology (1834) as she raised her children (The Works 10). Such anecdotes do not suggest that
these authors were necessarily experts in medicine, but rather that they lived in cultural milieus
in which new medical developments might be comfortably discussed alongside philosophical
arguments, literary trends, and current events. Indeed, it is only by synthesizing such disparate
and interdisciplinary concerns that this dissertation becomes possible.
21

I also want to emphasize that the interdisciplinary conversation I analyze is emphatically
reciprocal. I do not suggest that the epistemic virtues of time and space that stem from
sympathetic models were first realized within the medical field and then transferred to works of

20
Donald C. Shelton makes a fascinating claim that Carlisle was the inspiration for Shelley’s
earlier work, Frankenstein. See “Anthony Carlisle and Mary Shelley: Finding Form in a
Frankenstein Fog” for a detailed look at the relationship between these two figures.

21
Kennedy argues: “the literate British public was well informed of advances and controversies
in Victorian medicine” and traces current scientific practices and descriptions through a number
of periodicals circulated for the general public. For more, see Revising the Clinic, Chapter 2.

20
fiction. Too often, we analyze how new scientific practices affect cultural and textual practices
without fully examining the lines of influence in the opposite direction. Instead, I see fiction and
medicine as being in close conversation with each other during this historical moment, mutually
reflecting and refracting ideas across disciplinary boundaries. Like the authors and doctors I
discuss, I am less interested, were it even possible, in finding the origins of my object of study
and more interested in investigating the sometimes surprising relations and interconnections it
brings about.
22

My first chapter makes the counterintuitive claim that medicine shared a sympathetic
epistemology with a very different genre – the marriage plot. Jane Austen suggests such a
commonality in Sense and Sensibility (1811). For Austen, the marriage plot follows the same
trajectory as a medical narrative, and the final cure is a wedding. Reading Sense and Sensibility
as a medical narrative shows us the story of two sick patients suffering from disordered
sympathy both within their own bodies but also in relation to the larger social body. To be cured,
they must find their proper seat within their geographical and social spaces where proper
sympathy can be restored. The two sisters learn medical methodologies in order to treat first
themselves and then those around them in order to become healthy and happy wives. The
marriage plots of Elinor and Marianne are located in a medicalized time and space that illustrates
how to react to unpredictable events in a world governed by sympathy.

22
Daston and Gallison’s approach to causality is particularly apropos: “If some Laplacean
demon would turn its infinite industry and intelligence to a complete specification of all the
circumstances at a given time and place, wouldn’t it be possible to explain the emergence of
objectivity – or, for that matter, the outbreak of the French Revolution, the invention of the
magnetic compass, the rise of chivalry, yes even the onset of an avalanche – with pinpoint
precision? This is a persistent and revealing historical fantasy. It is fantastical to imagine that we
can deterministically identify not only the ‘trigger’ in historical processes – but also the detailed
route of development. It is impossible not only because it is practically beyond our grasp, but
also because it is incoherent” (50).

21
While Austen uses medical models to guide the stories of two young girls, Mary Shelley
applies the same models to the entire globe. My second chapter explores how Shelley uses the
logic of epidemics and the genres of the disaster novel and the travel novel to challenge the fixity
of national and racial identity in The Last Man (1826). The novel traces the life of Lionel
Verney, the sole surviving victim of a plague, as he watches his loved ones, nation, and finally,
the entire human race suffer and die around him. As the chronology of her story breaks down and
hope for the future becomes a relic of the past, Shelley increasingly relies on creating a
geographical narrative in which the sympathetic correspondence of individual and global events
creates a coherent story. My analysis centers around the encounter between Lionel Verney and
an unnamed “negro half clad” in which the two exchange breath and disease. Reading this scene
in terms of disease theory suggests that this scene is symptomatic not just of cultural difference
but also of a trans-cultural form of sympathy based on contingent contagion and the sympathetic
nature of disease as an organic force. As time and history grind to a halt, space is disconcertingly
reconfigured by shrinking geographical distances between Black and white bodies, which
threatens the cohesion of white identity even as it reinforces its sovereignty. By envisioning
spatial relations through the lens of sympathy, Shelley proposes a medico-moral philosophy that
builds on the precepts outlined by Austen in order to critique British global relations.
My third chapter analyzes Harriet Martineau’s sole novel, Deerbrook (1839), not only as
a “productive, if not sometimes frustrating, bridge between literary periods
”
but also one between
medical epistemologies (651). Situated between Romantic organicism and the rise of the realist
novel, Deerbrook acts as an intermediary between literary and medical movements.
Foreshadowing the social problem novels of the ensuing decades, Deerbrook retains the
sympathetic models of the recent Romantic past while also incorporating the burgeoning medical

22
theories of the present. The novel reflects the growing importance of miasma theory in
explanations of the mechanisms of epidemic disease, foregrounding the frustrations of uncertain
causalities at the same time that it reorients, in part, sympathetic models around poor working
bodies.
My project culminates with the argument that the social problem or “condition of
England” novel arises as the most popularized form of illness’s chronotopes. Focusing primarily
on Mary Barton (1848) as representative of the genre, I contend that social problem novels
depend on a sympathetic relationship between diseased body parts, sick individuals, and a
dysfunctional society that hearkens back to Romantic medicine and its conception of space and
time. The reciprocity between the part and the whole that the novel illustrates stems from the
Romantic idea that, for both bodies and communities, a part corresponds with the larger whole
through sympathetic communication – an idea that lived on in medical discourse about epidemic
disease. By typifying the working classes in the single body of the monomaniacal John Barton,
Gaskell adheres to a tenant of sympathy elucidated in the medical halls of London: “local
disease, injury, or irritation, may affect the whole system, and induce general disorder, --
characterized, however by more especial disturbance of some parts of the system” (“Mr.
Abernethy 5).
23
What holds true for a single biological body also holds true for the larger social
body.
One may note that all the authors I discuss in depth within these chapters are female. I
make no claims that the relationships between sympathy and disease that I discuss are the
exclusive purview of women’s writing. But although the gender of the authors does not play a
large role in my analysis, gender itself influences both my methodology and the cultural

23
“Mr. Abernethy.” The Lancet, vol. 3, no 54. 1824, 5-13.

23
construction of sympathy and disease.
24
Sympathy was a part of the “nervous medicine [that
associated] the female body with a greater susceptibility to nervous disorders by ascribing to it a
nervous system more impressionable than that of the male body” (Logan 23). And disease itself
was often associated with femininity even when experienced by men, while for women, the
nineteenth century saw “a socially conditioned epidemic of female illness.” (Gilbert 55). Chapter
1 and Chapter 3 particularly focus on the uneasy dichotomy between woman-as-nurse and
woman-as-patient, which illustrates healthy and diseased iterations of the sympathetic body,
respectively.
Perhaps most importantly, the narrative of the rise of clinical medicine usually elides a
tradition of feminine-inflected medical methodologies that exist alongside the clinical gaze.
25

Steady and close observation was a valued asset for female medical workers, including
midwives, herbalists, and professional and amateur nurses, even if they were often valued as part
of a tradition of maternal care and devotion rather than as increasingly masculine-inflected
techniques associated with scientific objectivity. Female medical workers and female authors
embraced female traditions of healing that extended older traditions of medical care while they
adopted the new language of clinical medicine. In a treatise about nursing for “inexperienced
young married lad[ies],” and for all others who may either become nurses or instruct nurses
within the domestic household, Elizabeth Bell Hanbury writes in 1825: “I conceive the cool

24
My methodology is indebted to a long history of feminist analysis that foregrounds the social
construction of bodies and the social construction of science. Although such foregrounding also
takes place in other disciplines such as critical race theory and disability studies, which also
inform this project, it is through the lens of gender studies that I first learned to think through the
slippery relations between culture and bodies and to recognize their interdependence.

25
For a more nuanced look at the varieties of female healing practices during the early
nineteenth century, see Summers, Anne. “The Mysterious Demise of Sarah Gamp: The
Domiciliary Nurse and Her Detractors, c. 1830-1860.” Victorian Studies, vol. 32, no. 3, 1989, pp.
365–86.

24
observation of such a woman may give a greater knowledge of the complaint than can be
possibly gained from a short visit from the physician. The one judges from facts; the other,
according to the best of his reasoning faculty” (20). The “cool observation” to which she refers is
a phrase more often used in praise of new masculine practices of medicine and her aspersion of
reason in favor of facts is, as we shall see especially in Chapter 1, a common growing sentiment
among doctors. Yet, she uses such language in service of a medical practice that is essential to
“the duties of a wife and mother” (xxv). In the novels that follow, Elizabeth Bennet, Margaret
Ibbotson, and Alice Wilson all explicitly co-opt the values of the new clinical medicine that
generally excludes their gender and combine such values with older and traditionally feminine
values of caregiving.
In addition to feminine analysis, my methodology blends cultural history with formalist
readings, allowing me to contend that the medical, philosophical, and cultural circumstances of
Great Britain in the early nineteenth century formed a particular historical nexus conducive to
exploring the problematics of realist narrative in a particular way. In other words, late-Romantic
and early-Victorian conceptualizations of sympathy contributed to a teleological epistemology
that influenced both medical and literary authors’ decisions about how to represent time and
space in narrative form. This is not to say that epistemology of sympathy was the only narrative
model available during this period nor that teleological forms of narrative occurred exclusively at
this time. Rather, I suggest that the historical circumstances of this moment foregrounded an
ahistorical epistemological problem of narrative and offered a historically relevant way of
thinking about it – one that continues to inform future thinking about narrative even as other

25
models came to the fore. In the tradition of Daston and Galison, “new epistemic virtues come
into being; old ones do not necessarily pass away” (41).
26

Finally, I must say a word about the medical texts I have chosen to include within this
project. Unlike scholars such as Kennedy and Tougaw, who have focused exclusively on case
histories due to their many formal similarities to the novel, I argue that while the case history
provides a provocative and important parallel to the novel, it is not the only medical form to draw
upon novelistic techniques and to focus on it exclusively would be to ignore important aspects of
the conversation between literary and medical fields. While the following chapters, especially
Chapter One, do include examples from case histories, they rely more on examples taken from
medical pamphlets and treatises that were circulated around the medical community and, to a
lesser extent, the general public. Such pamphlets often contained brief case histories but also
more general reflections about disease in the context of local, national, or even global
communities and environments. One may look again to Bleak House to understand the equal
importance of such reflections for the novelistic genre even amidst the narrative unfolding
ostensibly of a single individual.
27
I also include many examples taken from The Lancet, which
began publication in 1823 and represented the new professional class of medical workers and the

26
Additonally, the following methodological description from Daston and Galison inspires my
own analysis: “this is a history of dynamic fields, in which newly introduced bodies reconfigure
and reshape those already present, and vice versa. The reactive logic of this sequence is
productive…Sequence weaves history into the warp and woof of the present: not just as a past
process reacting its present state of rest – how things came to be as they are – but also as the
source of tensions that keep the present in motion.” 19

27
One may plausibly argue that Bleak House attempts to relate the narrative of a group of related
individuals rather than simply that of Esther Summerson alone. However, such a reading still
does not account for Dickens frequent and iconic reflections on society, such as his initial
description of London: “Fog everywhere. Fog up the river, where it flows among green aits and
meadows; fog down the river, here it rolls defiled among the tiers of shipping and the waterside
pollutions of a great (and dirty) city” -- a description that, incidentally, relates the great city to
the subsequent diseases of its central character through the miasmatic, polluted fog (5).

26
more scientific medical practices emanating from France. While the journal began with a
reformist agenda, it soon became an established authority in its own right not only for medical
practitioners but also for the reading public. By mid-century, the influence of The Lancet, for
better or worse, is suggested by Surgeon Henry Thompson, who complains in a different
periodical, the Cornhill, of the dangers of public consumption of the medical journal: “few
people make more mistakes than our medical amateur who, on the strength of a weekly perusal
of The Lancet at his club, sets up as an authority” (499). By incorporating a diverse array of
texts, I follow in Erin O’Connor’s mission to “piece together strands of thinking that nowhere
have a complete articulation, but which are present everywhere, albeit obliquely, in fragmentary,
diffuse form” (18). I have found that by considering multiple forms of medical writing, it is
possible to identify larger narratives of medicine that may be missed by only examining those
written in a traditional narrative form. In turn, these larger narratives cannot be fully understood
without the context of the increasingly prolific and influential narrative machine of the
nineteenth century: the novel.

27
Chapter One:
From Patients to Wives in Sense and Sensibility
Over the sixteen years between 1795 and 1811 while Jane Austen drafted Sense and
Sensibility, the medical world changed slowly, unevenly, and in ways difficulty to quantify. But
gradually, medical values shifted towards “the birth of the clinic:” a phrase often used as a
catchall for the late eighteenth and early nineteenth century shift towards modern medicine. The
easy term belies the complexity of the myriad of epistemological changes that took effect over
the course of decades. During Austen’s authorship, the laboratory science, centralized oversight,
and empirical analysis that would come to be associated with modern medicine were not yet in
place, especially in Great Britain, which adopted clinical medicine much later than France and
some other parts of Europe.
28
However, changes in epistemological values were already taking
place that would lead to these later phenomena. Perhaps most importantly, observation was
becoming an increasingly important epistemic virtue and an important precursor to what
Lorraine Daston and Peter Galison have called the “mechanical objectivity” of the mid-
nineteenth century.
29
While eighteenth-century physicians often drew upon the knowledge and
experience of their predecessors in order to bolster their medical authority and to confirm the
validity of their statements, doctors at the turn of the century were beginning to turn towards a
new kind of truth, one that came from precise, exhaustive observation and recording of the
phenomena and spaces of the human body.
30

28
For an elaboration on the medical history of Europe, see W.F. Bynum’s, Science and the
Practice of Medicine in the Nineteenth Century.

29
See Objectivity, section 3.

30
Meegan Kennedy perceptively distinguishes nineteenth century observation practices from
earlier forms of medical methodology that relied on insight and sensibility in Revising the Clinic:
Vision and Representation in Victorian Medical Narrative.

28
The increasing value of observation was in part due to the failure of theoretical models to
account for the origin and spread of disease. Theory allows scientists to predict what will happen
in the future by deciphering patterns in what happened in the past. Yet no theory, whether
humoral, contagious, or miasmatic, could fully account for either the wayward path of disease
through a community or the chain of its symptoms that progressed through the body. In 1828,
Dr. Uwins despairingly writes in a treatise on disease: “physical and moral man is so constituted
as to modify disordered manifestation to an extent very far beyond definable limits; as indeed, to
change circumstance into cause, cause into effect, incident into essence, and essence into
incident, almost ad infinitum” (2). Doctors knew that their theories could not explain the
relationship between cause and effect nor even which events were cause and which effect, often
prompting them to reject theory as a method of attaining knowledge altogether.
During the same year, one particularly fervent objector even goes so far as to declare:
“Theory is the bane of all science, has filled the libraries of the learned with unprofitable jargon,
and has in the medical profession done more injury to humanity, swept from existence more
human beings than ever did pestilence the most malignant” (Alderson 50). With a curious twist,
the author here conflates the deadliness of pestilence with the deadliness of the theory used to
explain it. His rhetoric attempts to shift the blame from the mysterious causes of disease to
theories employed by the physicians who fail to identify those mysterious causes. The amassed
knowledge of his predecessors, stored in “the libraries of the learned,” and which often included
the classical writings of Hippocrates, Galen, and Aristotle, becomes the virulent source of death,
rather than the means of solving it.
31
While the rhetorical flourishes of this author were

31
For more about what medicine looked like in Europe in 1790, just prior to many epistemic
shifts in the field, see W.F. Bynum, Science and the Practice of Medicine in the Nineteenth
Century, Chapter 1.

29
particularly dramatic, more moderate doctors also dismissed the theoretical knowledge of past
generations. In 1827, Dr. Armstrong reflects to his students: “It is most lamentable to look back
to remote times, and to consider how many centuries were wasted by the vain and unprofitable
speculations of our ancestors, who… sought for truth, not in the great world without them, but
within their own little minds” (324). This latter quotation banishes theory as a relic of the past in
punishment for its lack of ability to speculate reliably about the future. A doctor could not rely
on the wisdom of his predecessors to predict accurately the course of disease.
Because doctors viewed the theoretical knowledge of the past and its predictions about the
future with a related and equal suspicion, knowledge garnered in real-time observation was
considered the most objective means of finding truth. As a result, the medical profession
espoused an ethical stance towards time that focused on the present moment to the exclusion of
the past or future. Observation without conjecture or dependence on theory and without
predicting the future or relying on evidence of the past was the only reliable way to acquire
knowledge.
Amidst the tumult of this epistemological shift, Dr. Moir of Edinburgh describes
medicine by 1832 as a “humiliating and melancholy subject,” lamenting: “There seems to be no
common medium of observation– no acknowledged or predetermined plan of prosecuting
enquiry– little of discrimination between fact and conjecture, and less of distinction of effects
from causes” (9). Dr. Moir’s lamentation outlines four methodologies that he considers to be
lacking in his field: a controlled environment for data collection, predetermined procedures for
how to seek truth, separation of facts from conjectures, and causes from effects. Together these
practices would build an epistemology that could reliably dictate the treatment and cure of sick
patients. While doctors desired to adhere to these practices, they did not always have the means

30
to do so. Dr. Moir takes solace in the fact that “happily, for the honour of medicine as an art, its
principles are not so mercurial and baseless, as some would fain lead us to believe… It is
aboundingly rich in its store of observations” (9-10). Accurate observation is the particular
strength of a field that acknowledged its own weaknesses in building a chronology of disease. If
all else fails, rely on your own senses. The ideal of pure observation could not completely be
realized, of course; one had to detect patterns and apply knowledge for observations to be of any
use. Nonetheless, physicians often tried to navigate the often-mystifying field of medicine by
relying solely on facts seen with their own eyes and to avoid speculation about how such facts
related to each other in terms of cause and effect.
This is not to say, however, that physicians ignored all relationships between the facts they
observed. While building chronologies of disease that depended on understanding modes of
transmission or the internal workings of the body seemed impossible, they did rely on one
medical theory that did not depend on such mechanisms. That theory was sympathy, which
united body and soul, individual and community, and space and sociality. What Christopher
Lawrence has noted as originating in the medical hub of Edinburgh can be applied more
generally to British thinking from the mid-eighteenth to early-nineteenth century: “[a]s society
was held to depend on the mutual feeling, or sympathy, between the parts, so too, was the body.
In the same way that the [city] elite perceived itself, so the nervous system was seen as a
structure of interacting sensibilities, binding together and controlling the whole” (33). In other
words, biological life functioned like a series of Russian dolls; a diseased part corresponded to
and nested within the disease body, which corresponded and nested within a diseased
community. To understand the workings of one part was to understand the workings of the whole
system and vice versa. In this respect, life, both healthy and diseased, functioned through

31
synecdoche; a part could reliably stand in for the whole. Physicians attributed the contiguity
between body parts, individuals, and communities to sympathetic influence.
What may at first appear startling is the fact that sympathy governed the marriage plot just
as much as it did the field of medicine. At least Jane Austen seems to suggest such a
commonality in Sense and Sensibility in which Marianne and Elinor must interpret the
sympathetic relationships between their social spheres and their own bodies. Moreover, their
successful interpretation depends on precisely those epistemological virtues that Dr. Moir lauds.
The two sisters must find a controlled and stable environment, plan, and discriminate between
fact and conjecture, as well as effects and causes to navigate the marriage plot and find husbands.
While the amorous trials of two fictional young girls may seem to have little to do with the
methodological complaints of a real-life physician, Marianne, Elinor, and Dr. Moir do face
similar problems about how to categorize knowledge. How can one interpret behavior without
knowing its cause? The question is equally urgent whether it refers to a mysterious suitor or an
unknown disease. Austen’s novel grapples with the same epistemic concerns as many
contemporary treatises on epidemics and her advice for young women seems to be like that given
to young doctors: plan, don’t theorize, and above all, observe.
Austen’s Sympathetic Style
To speak of Austen as a writer particularly concerned with the vagaries of corporeality is to
go against a long tradition of critics who have either condemned or celebrated her “out-of-body
voice” (Miller 1). Perhaps most famously, Mark Twain wrote that “every time I read that mangy
book, Pride and Prejudice, I want to dig her up and beat her over the skull with her own shin-
bone” (421). Presumably his complaint alluded to the lack of bodily substance in her writing;
preoccupied with convention and civility, she needed a swift kick to the head with the reality of

32
her own foot. Yet, Austen had already envisioned her own writing as inscripted upon organic
material, not quite upon the morbid reality of her own shin-bone but rather upon its near cousin:
“the little bit (two Inches wide) of Ivory on which I work with so fine a Brush” (Letters 337). It,
like its skeletal counterpart, was once part of a living body and it is this body part that provides
the backdrop that makes her minute artwork possible. Austen’s piece of ivory may seem, to be
sure, too dry, too dead, and too small to hold the expansive social world of her novels, but she
transforms it into something much greater and more complex than the piece of tusk that it once
was.
Austen’s ivory provides the perfect metaphor for her approach to writing. The social
conventions and marriage plots with which her novels are principally concerned may appear to
be divorced from the physical description and messy inconveniences of actual bodies, but they
are in reality predicated on exactly those bodies which she appears to ignore. One might even say
that bodies are indeed the backbone, although perhaps not the shin bone, of her marriage plots.
However, later readers of Austen might have difficulty identifying the corporeality of Austen’s
writing because it depends upon a concept of sympathy which had lost most of its biological and
pathological connotation by the middle of the nineteenth century. During Austen’s time,
sympathy dictated that the relationship between an acutely symptomatic body part and the
general constitution of the sick body frequently mirrored the relationship between a sick
individual and the general health of a plague-stricken community. Austen’s minute brushstrokes
on her tiny piece of ivory function as a synecdoche for a fictional world much greater than the
single body part upon which she writes, yet that fictional world is influenced by the bodies and
body parts of its characters.

33
Sympathy was a profoundly physiological phenomenon that traveled through the nervous
system. Dr. Lawrence explains in a lecture in 1829 that the sympathy of “the nerves, with the
brain and spinal chord, [that] afford[ed] an explanation how the various organs [were] connected
together in their morbid, as well as in their natural functions” (“Lectures on Surgery” 69). Not
merely internal to the body, however, sympathy could also connect people and transfer sentiment
through the senses; the eyes and ears could perceive the emotional and physical condition of
others and, through the nervous system, affect the condition of the observer. For those with
particularly sensitive nervous systems, even imagining the sight or sound of another might
induce a nervous response.
32
Sympathy was the medium through which physical and emotional
states traveled, causing people or their body parts to take on the characteristics of their perceived
surroundings.
Sympathy, as we shall see, shapes the plot of Austen’s first novel, Sense and Sensibility,
but just as importantly, it shapes Austen’s style, a style perhaps best known for its frequent and
exquisite use of free and indirect discourse. As D. A. Miller has noted:
The significance of free indirect style for Austen Style is not that it attenuates the stark
opposition between character and narration, much less abandons it, but that it performs
this opposition at ostentatiously close quarters. In free indirect style, the two antithetical
terms stand, so to speak, as close as possible to the bar (the virgule, the disciplinary rod)
that separates them. Narration comes as near to a character’s psychic and linguistic reality
as it can get without collapsing into it. (59)

32
“It is to be observed, that strong nervous symptoms are seldom occasioned by fear, terror,
grief, the force of imagination, or any sudden impression on the organs of sense, in person whose
nerves are firm and less sensible; but, when the contrary is the case, the causes above mentioned
will often produce the most sudden and violent hysteric fits, or convulsive disorders” (Whytt
222).

34
Austen’s use of free indirect discourse performs through text the same function as sympathy does
through the senses. Free indirect discourse blurs the boundaries between the feelings, thoughts,
and sensations of character and author, bringing the reader, without the warning of quotation
marks, into an unexpected intimacy with both. Yet, this resonance never slides into complete
correspondence. Sometimes this brief moment of closeness even provokes a subsequent
revulsion as the reader recoils from the thoughts that are presented as at least partially the
narrator’s and yet contain content foreign to the narrator’s style or personality.
33
Such is the case
when the narrator assumes the sentiments of Mrs. John Dashwood to declare: “It was very well
known, that no affection was every supposed to exist between the children of any man by
different marriages; and why was [Mr. John Dashwood] to ruin himself, and their poor little
Harry, by giving away all his money to his half sisters?” (11). While Austen’s use of free indirect
discourse in this instance is satirical, it still brings both narrator and reader in uncomfortably
intimate proximity to Mrs. John Dashwood’s thoughts before we can pull away.
In other instances, this mode of discourse is less satirical. Austen reveals the relationship
between free indirect discourse and sympathy most clearly much later in the book during
Marianne’s almost-fatal illness. Here, the narrator adopts the persona of Elinor as she rushes to
the door with news of Marianne’s recovery and expects to greet her mother who does not know
if her child is alive or dead: “The knowledge of what her mother must be feeling as the carriage
stopt [sic] at the door, – of her doubt– her dread– perhaps her despair! – and of what she had to
tell! – with such knowledge it was impossible to be calm” (293). Form matches content as the
narrator adopts the sentiments of Elinor through free indirect discourse even as Elinor through
sympathy experiences through sympathy the sentiments she believes to come from her mother –

33
I discuss revulsion in relation to sympathy in more depth in Chapter 2.

35
the doubt, dread, and despair. The text forms a chain of sympathy whereby Elinor, the narrator,
and the reader all briefly share in Mrs. Dashwood’s turbulent emotional state – a state that affects
Elinor’s nervous system with its agitation and makes it impossible for her to remain calm. On
Elinor’s sensible body, the physiological force of this sympathy is no less real because it is
imagined and turns out to be premature (it is Willoughby, not Mrs. Dashwood, at the door).
When Mrs. Dashwood does arrive an hour later, the flow of sympathy is reversed as Elinor “gave
the joyful relief” to her mother who “catch[es] it with all her usual warmth” and “was in a
moment as much overcome by her happiness, as she had been before by her fears” (312). The
instantaneous transfer of emotion in this sympathetic encounter brings the characters’ “psychic
realties,'' not to mention the states of their nervous systems, closer together even as Austen’s free
indirect discourse brings the narrator and character’s “linguistic realities” closer together.
34

The Pathology of Sensibility
That Austen’s style formally draws attention to the sympathetic mechanisms that undergird
her plots is nowhere truer than in Sense and Sensibility, where the title overtly addresses, at least
to her contemporary readers, pathological aberrations in the healthy functioning of sympathy.
Physicians in the eighteenth and early nineteenth centuries classified bodies by the acuity of their
nervous sensibility, which determined the ease with which sympathy traveled through their
systems. The lower class and colonized cultures were often associated with low sensibility,
which limited their ability to experience empathy or appreciate beauty but also preserved their

34
D.A. Miller reads Austen’s style as “only emerg[ing] at the expense of substance” with the
implication that this accounts for the “out-of-body” voice I allude to earlier (17). In other words,
Austen’s unique, universalizing voice, comes at the expense of her body. However, I argue that
the body actually appears most clearly at those precise moments of free indirect discourse that
best characterize Austen’s style. Because nervous sympathy connects physical bodies and social
milieus, these moments accentuate the importance of the nervous system in bringing narrator and
character closer together.

36
health. As Dr. George Cheyne remarked in his influential The English Malady (1733): “I seldom
ever observ’d a heavy, dull, earthy, clod-pated Clown, much troubled with nervous Disorders”
(262). On the other hand, the middle- and upper-class, especially women and intellectuals, were
associated with high sensibility that formed a “nervous temperament.” Those with a nervous
temperament exhibited a high degree of sympathy for others and Dr. Thomas Trotter claims in A
View of the Nervous Temperament (1807): “it is this degree of feeling that too often makes it the
sport and victim of passion.” Dr. Thomas Trotter goes on to note that “In this temperament of
the sentient system, a genius for the elegant arts chiefly originates. The poet, painter, and
musician, may be justly styled genus irritable vatum” (164). Yet, such talent comes at a price.
Nervous temperaments caused fickle tempers, unequal spirits, and equivocal attachments. Trotter
observes:
In business they are indecisive, unsteady, and impracticable. Their friendships are often
puerilish and their resentments unmanly. Amidst domestick [sic] connections, they are
apt to teaze [sic] their relatives by the observance of trifles; while concerns of importance
are frequently degraded by an ill-timed levity. Much of their time therefore is spent in
making concessions to others for the inordinate ebullitions of passion; or in torturing
themselves by groundless fears, or imaginary affronts. (163)
Such ambivalent descriptions provided the basis for ongoing debates about the merits of
sensibility long before Austen’s novel. Proponents of the “cult of sensibility” extolled the
intensified compassion, refinement, talent, and emotion associated with a delicacy of nerves.
Skeptics, however, emphasized the propensity for sensibility to turn into voyeurism, narcissism,
and even sadism. As Inger Brodey has elegantly put it: “The apex of sensibility’s glory…is the
radical idea that through human imagination we can overcome our separation from one another

37
and approximate others’ feelings… The nadir is when sensibility becomes a hypocritical excuse
to relish stories of others’ suffering for the purpose of enhancing our social status, satisfying our
vanity, or indulge in our darkest sexual fantasies” (69).
35

As the title Sense and Sensibility might suggest to a contemporary reader, Elinor and
Marianne both suffer from similar nervous disorders. As Ros Ballaster reminds us, “‘sense’ and
‘sensibility’ are etymological relatives rather than linguistic strangers” (xxiii), and
acknowledging the kinship between the terms seems particularly important in a novel in which
they describe two sisters.
36
At the time Austen was writing, sense could mean “natural
understanding or intelligence” and the “ability to make sound judgements,” but it could also
mean “the bodily senses considered as a single faculty in contrast to intellect, reason, will, etc”
(“Sense”). In other words, the term “sense” could describe not only the sober reasoning ascribed
to Elinor but also the heightened sensation apparently experienced by Marianne. Sense and

35
See Eve Kosofsky Sedgwick’s “Jane Austen and the Masturbating Girl” for the slippage
between sensibility, creative art, and auto-eroticism, or masturbation and the manifestations of
these slippages in the behavior of Marianne.

36
Meegan Kennedy has rightfully claimed that Austen is experimenting with the genre of the
case study in Sense and Sensibility (21). Consider a similar case study written by the surgeon
Humphrey Sandwith as he defends his practice of bleeding patients who manifest particular
symptoms of typhus fever: “It is not a little singular, … that each of the little boys, whose deaths
I am deploring, had a brother severely, though in some measure differently, attacked by the
fever; in both which cases I bled, and they recovered. Thus in each family, apparently from
difference of treatment, ‘one was taken, and the other was left!’ (22-3).” Despite drastically
different genres and durations of discussion, the two texts share very similar plots. Each
compares the results of good treatment with the results of bad treatment on suffering siblings and
each participates in similar epistemological projects that assume that general knowledge can be
extrapolated from the experience of a single family. Kennedy has provocatively shown that this
project is not limited to Sense and Sensibility but rather is a hallmark of both case histories and
novels, which are “perched… between an individual and more general knowledge” and share and
adapt many ways of “seeing and stating” as they both gain popularity in the eighteenth and
nineteenth centuries (21). The two genres share an investment in recounting an objective reality
that “promised to record observations with more objectivity, accuracy, precision, and reliability”
(55).

38
sensibility connoted not only refined taste and compassion, but also dangerous nervous
susceptibilities.
These two sensible sisters share remarkably similar feelings, responses, and life events.
Both fall in love with men who are engaged elsewhere and who receive familial pressure to
reject the Dashwood sisters. But more importantly, Elinor and Marianne suffer from these events
and others in similar ways. After their father’s death, Marianne experiences a “violence of…
affliction,” but Austen reminds us that Elinor, too, was “deeply afflicted” (9). Marianne’s
“restless pain of mind and body” that causes her to move “from one posture to another” is
accompanied by Elinor’s pacing “thoughtfully from the fire to the window, from the window to
the fire, without knowing that she received warmth from one, or discerned objects through the
other” (180). And in response to Marianne’s accusation that her sister does not feel as greatly as
she does, Elinor delivers a monologue riddled with dashes that reveal her agitation and which
lists all of her sufferings, concluding with: “If you can think me capable of ever feeling – surely
you may suppose that I have suffered now. The composure of mind with which I have brought
myself at present to consider [her romantic situation], the consolation that I have been willing to
admit, have been the effect of constant and painful exertion; -- they did not spring up of
themselves;-- they did not occur to relieve my spirits at first” (245). Elinor must use considerable
will to counter the acute sensations that she experiences, which are akin to Marianne’s.
Time and again, the novel suggests that despite appearances, Elinor suffers from a
sensibility that is just as refined as her sister’s and therefore possesses a nervous system that is
just as pathologized. For nineteenth century readers, such an affliction could be every bit as
serious as typhus fever. Trotter writes that “disappointed love” acting on the “sensible female
frame… commonly, sooner or later, produce some disease of the nervous system, which quickly

39
draws into consent the digestive organs, and others of equally acute sensibility.” He concludes
that “the separation of parties, and the long engagements that procrastinate marriage, are often
fatal to health” (86-8) Trotter’s observations reveal an underlying assumption that marriage
equates with health, an assumption amply illustrated by Austen’s later novel. For Marianne, the
effects of an impossible love on her overly sensible body does prove almost fatal. However,
Elinor’s suffering is just as severe and equally in need of succor. Speaking about a reviving glass
of wine offered to Marianne, Elinor reflects that the “healing powers on a disappointed heart
might be as reasonably tried on herself as on her sister,” suggesting that although her outward
symptoms might not be as dramatic, the affliction of her heart break is just as dire (187).
Furthermore, Elinor’s suffering more frequently occurs in response to the suffering of others,
suggesting if anything, an even greater sensibility than her sister. In response to Willoughby’s
cruel behavior towards Marianne, Elinor “gave way to a burst of tears, which at first was
scarcely less violent than Marianne’s” (173). And later when Elinor sits beside her gravely ill
sister, the night brought “almost equal suffering to both,” the one suffering from “pain and
delirium” and the other suffering from “the most cruel anxiety” (291). Because anxiety is exactly
what has led to Marianne’s acute illness in the first place, this passage suggests that Elinor’s
sympathetic suffering presents a significant danger and that she, like her sister, requires
appropriate treatment to achieve lasting health.
Sympathy and Synecdoche
By foregrounding the problematic sensibility of both sisters, Austen reveals that her
marriage plot is also a medical plot — and that the body that so many of her critics have not
detected in her writing is in fact at the center of her novel.

40
However, such critics may have understandably been looking in the wrong places
because disease occupies different kinds of spaces in a world that is governed by sympathy.
Because sympathy linked micro- and macrocosmic organic systems, disease equally infected the
inner spaces of the body and the environment at large. Pinpointing these locations was an
important pre-cursor to treatment. As Mr. Lawrence tells his students in 1829: “It is the object of
medicine to ascertain the nature and seat of diseases, in order to discover the proper modes of
treating them” (“Lectures on Surgery” 65). “Ascertaining the seat” meant locating the part of the
body that had the most acute pathology and locating the types of environment that generated
disease and “discovering the proper mode of treatment” often depended on determining the
sympathetic relationship between such macro and micro spaces. Disease was so completely
linked with the space that it occupied that location became a metonym for the disease itself. As
Dr. Joseph Adams noted in his 1809 treatise on disease: “if any illness exists, or as soon as
illness is produced…, a new kind of air is generated, which produces a fever called usually by
the name of the place where the event has occurred, whether a camp, a ship, or a poor house, jail,
or hospital” (11).
It is little surprise, then, that Elinor and Marianne’s locations affect their physical
wellbeing. The social and bodily ailments of Elinor and Marianne prove to stem from the same
problems, which simply manifest on different scales. At each of the six locations that Elinor and
Marianne reside during the novel, their environment dictates the nature and acuity of the
symptoms of excess sensibility that they suffer. The bustling social life of London and the close,
but not close enough, proximity of Willoughby marks a period of heightened agitation for
Marianne who suffers particularly from the unaccustomed stimulation of her nerves. The coming
and going of visitors exacerbates her symptoms because her “nerves could not then bear any

41
sudden noise” (192). Likewise, the proximity of their brother coupled with the continual flow of
gossip available in London is enough to “agitate [Elinor’s] nerves and fill her mind.” Elinor
seems to acknowledge the role that her location has on the state of health when she looks
forward to leaving London and “to what a few months of tranquility at Barton might do towards
restoring Marianne’s peace of mind, and confirming her own” (283). However, before the sisters
can reach the safety of Barton, they must visit Cleveland where Marianne, prompted by the
extravagances of her excess sensibility, roams through “longest and wettest” grass in the
“wildest” part of the grounds (186). The combination of internal nervous disorder and exterior
environment culminates in a life-threatening putrid fever.
Some scholars have dismissed the apothecary’s diagnosis of putrid (and therefore
infectious) fever as simply a “mechanism of the plot” assumedly because Marianne’s sickness is
so clearly related instead to her nervous sensibility.
37
Such scholars commit an anachronism by
separating infectious diseases from nervous diseases. Because sympathy simply denoted the
susceptibility to internal and external impressions upon the body, it was implicated in all disease.
Those with acute sensibility were more vulnerable to the external triggers of miasma or
contagion. According to the medical reporter of Ackermann’s Repository (1809), the “cloudy
foggy atmosphere” in which Marianne chooses to wander can seriously affect the health of
“nervous people and those subject to lowness of spirits” (“Medical Report” 50). Moreover, the
nervous complaints associated with increased sensibility were thought to increase the likelihood
of contracting certain kinds of fevers.

Charles Whitlaw writes in A Treatise on the Causes and
Effects of Inflammation, Fever, Cancer, Scrofula, and Nervous Affections (1831) that spotted

37
See Kaplan’s “What is Wrong with Marianne?” Also see Introduction by Tony Tanner which
claims Marianne’s illness is (somewhat anachronistically) psychosomatic (361).

42
fever, “the most pestilential fever of Europe,” is most dangerous to “[P]ersons of a lax habit,
melancholy disposition, and whose vigour has been destroyed by drastic purgatives, and nervous
complaints” (126). Marianne’s putrid fever is therefore a medically plausible culmination of her
chronic and untreated nervous disorder; her excess sensibility causes her to imbibe the
insalubrious atmosphere of Cleveland to a greater degree.
38

Everywhere the sisters travel produces a physical change in their health that is best
understood through the flow of sympathy between body parts, individuals, and their
communities. Rather than “ship fever” or “jail fever,” Elinor and Marianne may well be
diagnosed with “London fatigue” or “Cleveland fever.” The social milieus that many have read
as entirely divorced from the body are actually profoundly linked to the bodily dysfunction of the
two sisters. The disordered sympathy that causes Elinor’s and Marianne’s nervous afflictions is
mirrored in the disordered sympathy that affects their social world across many geographical
locations.
39

38
The medical language of sensibility was often employed in sentimental novels as part of a
trope in which a young woman would experience heartbreak and then fall ill and die. See
Claudia Johnson’s “A ‘Sweet Face as White as Death’” for a cogent reading of Sense and
Sensibility as a critique of such sentimental novels. She argues that “The crucial structural fact of
Sense and Sensibility -- a fact which criticism has not confronted – is that male characters, not
Austen’s narrator, are the tellers of heroines’sad stories. Each transforms the heroine’s story into
a highly conventionalized narrative about himself, a narrative saturated with the kind of jargon
Austen always satirized” (166). The heroine of Austen’s narrator, of course, does not die, but
recovers with the help of her sister.
39
As James Brown points out, despite Austen’s sparse description of landscape, she was careful
to convey precise geographical detail. For example, she wrote to her sister Cassandra asking
about the nature of the hedgerows in Northamptonshire while writing Mansfield Park (Brown
23). For Austen, the plot depends upon an accurate depiction of localities, but even more
importantly upon the relations between them. This accuracy was both physical (she warns her
niece that if she writes about characters traveling from Dawlish to Bath, they must travel for two
days) and social (She similarly advised her niece not to write about Ireland because she did not
know the local manners) (Brown 23). To put it another way, Austen’s localities are frequently
differentiated not only by their physical descriptions but also by the social sympathies that exist
there. As Brown concludes, “There is a sense… of social and economic networks of connections
being overlaid on the terrain, enabling or limiting movement across it” (27). Austen shares this

43
Much of the sister’s journey, then, can be thought of as finding the right “whole” to be a
“part” of, or rather, finding a salubrious geographical and social position that will have a healthy
sympathetic influence on their nerves. If for physicians “assigning the proper seats of diseases”
is one of the primary goals of medicine and the first step towards cure (“Lectures on the Theory”
225), Elinor and Marianne must act as their own physicians and identify their own “proper seats”
in order to affect their cure although the seats in question are their individual positions within the
larger social body. Identifying the wrong seat, such as “Combe Magna, [Willoughby’s] seat in
Somersetshire,” could lead to catastrophic results for Marianne’s fragile nervous system (188).
Indeed, from the very first lines of the novel, Elinor, Marianne, Margaret, and Mrs.
Dashwood are all displaced from their proper seat through a problematic synecdoche: “The
family of Dashwood had been long settled in Sussex” asserts that the male landowners of the
family might successfully be indicative of all Dashwoods, a statement which disregards the fate
of female descendants and younger sons who have assumedly been displaced.
40
This first
statement ironically contrasts with the events that immediately follow: four female members of
the Dashwood family are summarily “degraded to the condition of visitors” in the Sussex family
home by their male relative and his wife, reminding us that the “family of Dashwood” does not
actually encompass everyone who goes by that name. As the novel goes on to show, it is
precisely two of these displaced female descendants, Elinor and Marianne, whose persistent
symptoms complicate (and drive) the plot. For the narrative to reach a satisfactory resolution,
Marianne and Elinor must return to families –families that, within the logic of Austen’s marriage

sense with her medical contemporaries, who envisioned disease and sympathetic susceptibility to
disease as similarly overlaid on the terrain.

40
Margaret Anne Doody discusses this synecdoche amongst others in “Turns of Speech and
Figures of Mind” in A Companion to Jane Austen.

44
plots, must include a husband – and integrate as individual parts of a larger social whole. Doing
so will allow them to occupy a stable geographical position from which to view and relate to the
world, or to invoke again Dr. Moir, find a “common medium of observation.” Much of the novel,
therefore, is preoccupied with repairing the damage caused by its initial exclusionary synecdoche
and returning the sisters to a sympathetic position in both geographic and social space.
Along the way, Marianne and Elinor must navigate a number of misunderstandings about
the relationship between parts of bodies and the wholes to which they belong, experiences which
educate them about what appropriate sympathy does and does not look like. Elinor mistakenly
believes the lock of hair that Marianne gives to Willoughby represents the larger idea of their
engagement. Similarly, Elinor first mistakes the lock of hair that Edward Ferrars wears as her
own hair, and when she finds out it is in fact Lucy’s, she makes the equal mistake of believing it
represents his love for Lucy. In each case, understanding the meaning of a minute body part (a
lock of hair) requires Elinor to identify both the body to which it belongs and the nature of the
sympathetic relationship between the part and the whole. As Margaret Anne Doody notes, “Any
instance of synecdoche demands that the reader perform a mental suture to restore the part to its
larger whole. But a particular lost part might not belong to the whole we imagine for it” (172).
The use of the word “suture” seems particularly relevant here because the synecdoches in Sense
and Sensibility require an act of healing that reestablishes the relationship between parts and
bodies as well as bodies and communities. As Elinor and Marianne begin to observe the proper
relationship between the organic parts and larger wholes around them, they acquire knowledge
that eventually will lead to the restoration and healing of their own nerves.

45
Treatment for the Nervous System
Elinor learns the lessons of health far more easily than her sister. If they suffer from
similar nervous complaints, why does Marianne come close to death while Elinor remains
relatively unscathed? The difference lies in how Elinor and Marianne treat the bodily
manifestations of their sensibility; differing treatment leads to differing outcomes. Although both
possess the underlying predisposition for nervous disorder that accompanies sensibility, Elinor’s
more clinical treatment of her nervous symptoms help to combat the disorder while Marianne’s
lack of systemic treatment exacerbates it.
41
In other words, Elinor embraces exactly those
methodologies that were extolled at the beginning of this chapter by Dr. Moir, and in doing so
she adopts a philosophy about how to approach time and the chronology of her life in a healthy
way. As Elinor makes plans, she is careful to use “discrimination between fact and conjecture”
and make “distinction of effects from causes” in ways that Marianne does not. When such
methodology proves impossible, she does not engage in useless theorizing but sticks to the facts
she knows in the present moment.
42
Elinor’s approach to her own susceptibilities allows her to
treat her symptoms successfully, transitioning from a patient to a doctor. Marianne, on the other
hand, identifies as a patient throughout most of the novel.

41
In Reading for Health, Erika Wright claims that Elinor and Marianne differ in their modes of
prevention rather than in their modes of treatment in order to emphasize the importance of
preserving health in Austen’s time period. Rather than refuting Wright’s perceptive argument, I
suggest that the text relies on both kinds of narrative (health and disease) and that the ambiguity
between prevention and treatment reflects a similar ambiguity in medical narratives about what
constitutes disease and what constitutes the precursors to disease. In many ways, however, both
sisters do appear to have symptoms of disease from the beginning of the novel, which is why I
privilege the disease narrative in these pages.

42
It is important note that Elinor does not always avoid making speculative conclusions based
the evidence she has (even if it is incomplete). However, she does avoid acting on such
speculations or letting them affect her behavior.

46
Much like the ideal physician of the time, Elinor participates in a world of “probabilities
and proofs” and refuses to let her own wishes sway her observation of the facts (133, 136).
43

From the beginning, Elinor’s “strength of understanding” and “coolness of judgement” is
contrasted with her mother’s and sister’s “eagerness of mind” which leads to being “everything
but prudent’ (8). In other words, Elinor has the ability to make premeditated plans and sober
decisions based on current facts while her family does not. When Lucy Steele reveals her
engagement to Elinor’s love Edward Ferrars, Elinor reflects: “the picture, the letter, the ring,
formed altogether such a body of evidence, as overcame every fear of condemning him unfairly,
and established as a fact which no partiality could set aside, his ill-treatment of herself” (133).
Elinor frames her situation in terms of objective fact and observation to diagnose her own
suffering, acting, as Erin Wilson has noted, as that an observing physician charting symptoms,
lulls, and improvements” (282). Moreover, she counters the “ill-treatment” of Edward with her
own restorative treatment based on her own diagnoses. Elinor acts in accord with medical
practitioners like Trotter who argue that the best treatment for nervous disorders is to avoid
“indolence of body or mind, or vicious indulgence of any kind inconsistent with health” (237). In
Elinor’s case, this means “constant and painful exertion” to avoid indulging in fantasy or being
swayed by her own desires into an inaccurate understanding of her own situation. She steadfastly
remains in the present by strictly minimizing her speculations about Edward’s motives or about
her own future and thereby avoids acting on spurious relations between causes and effects. In
other words, Elinor treats herself effectively as a patient by choosing to identify instead as a
doctor; the medical gaze is the cure for her overly sensitized sensibility.

43
Laurie Kaplan has noted that “Jane Austen examined the foibles of people as carefully as the
best medical men scrutinized their physical findings” (117).

47
Conversely, Marianne rejects such objectivity and embraces the role of a patient. Near
the beginning of the narrative, Elinor chides Marianne by asking: “is there not something
interesting to you in the flushed cheek, hollow eye, and quick pulse of a fever?” (40). Although
Elinor is here referring to taste in men, the question proves to apply to Marianne’s own body as
well. She consistently nurtures the symptoms of nervous sensibility that lead to hysteria and
eventually the fever foreshadowed by Elinor. In direct contradiction to Trotter’s advice,
Marianne indulges in “moments of precious, of invaluable misery” that exacerbate her nervous
symptoms (283). Restless and with her mind “never quiet,” she slowly declines over the course
of several months (161). Her friends observe her looking unwell; she feels faint, experiences
nervous irritability, suffers from “nervous head-akes,” grows pale and thin, and does not eat or
sleep (175). Her indulgence eventually extends to “sitting in her wet shoes and stockings,” which
results in the fever that she finds so interesting in others.
Marianne’s self-treatment for her nervous anxiety is limitless speculation about the
future; she behaves as if she is betrothed to Willoughby despite having no proof of his intentions
and she assumes certain events (Willoughby’s flirtations) will cause certain actions (their
marriage) despite no concrete evidence. False assumptions plague every phase of her relationship
with Willoughby. As she waits for Willoughby to come to town, she is “all the time busy in
observing the direction of the wind, watching the variations of the sky and imagining an
alteration in the air.” She reasons that the warm weather has kept Willoughby in the country
hunting and that colder weather will bring him to her. She sees “every night in the brightness of
the fire, and every morning in the appearance of the atmosphere, the certain symptoms of
approaching frost” (160). Of course, unbeknownst to Marianne, Willoughby is, in fact, already
in town and has avoided visiting her because he is courting a richer woman. But Marianne

48
persists in seeing the “symptoms” that she wants to see, diagnosing the weather based on her
wishes and not on unbiased observation.
Even after Willoughby’s intentions have become all too clear, she continues to theorize
about his motives for wooing and then deserting her and obsesses over finding the cause to his
actions: “Sometimes she could believe Willoughby to be as unfortunate and as innocent as
herself, and at others, lost every consolation in the impossibility of acquitting him” (192). She
uses precisely those fallacious modes of reasoning which Dr. Moir decries: conflating fact with
conjecture and cause with effect. By choosing the wrong medical methodologies to treat her
pain, she acts as a bad doctor and prolongs her role as a patient.
Marianne’s eventual cure lies in emulating her sister in identifying as a medical
practitioner instead of a patient. Marianne initially assumes that any woman marrying Colonel
Branden would be bringing “herself to submit to the offices of a nurse, for the sake of the
provision and security of a wife” (40). Though she treats this idea with contempt, she herself
becomes his bride by the end of the novel, giving up her philosophy of sensibility for one of
practicality: “Instead of falling a sacrifice to an irresistible passion, as once she had fondly
flattered herself with expecting… she found herself at nineteen, submitting to new attachments,
entering on new duties, placed in a new home, a wife, the mistress of a family, and the patroness
of a village” (352). Eighteen years Marianne’s elder, Colonel Brandon probably will need those
nursing services that Marianne initially despises. Austen wryly reminds us that Colonel Brandon
“still sought the constitutional safe-guard of a flannel waistcoat,” which Marianne began the
novel believing “is invariably connected with aches, cramps, rheumatisms, and every species of
ailment that can afflict the old and the feeble” (352, 40). While the comment satirizes Marianne’s
initial assumptions about Colonel Brandon’s health, which appears good despite a rheumatic

49
complaint, it also reminds us of his own future vulnerability. For Marianne, accepting the
prospect of nursing her husband through his declining years appears to be an important sign of
her own improved health, and moreover, the sign of her fitness for marriage as medical narrative
and marriage plot meld into a single story. Marianne’s acceptance of her new duties prevents the
“indolence of body or mind” associated with dangerous sensibility and the course of her health,
hindered until now by incorrect treatment, appears to be corrected by a similar treatment to that
which her sister had earlier adopted.
44
Marianne and Elinor both begin the novel as patients and end it as wives, although Elinor
makes this transition much more easily due to her efficacious treatment of her own nervous
sensibility. Austen’s conflation of medical narrative, which transitions from patient to survivor,
and marriage plot, which transitions from single woman to wife, is made possible by the rules of
sympathy that govern both kinds of plots. Viewed through either lens, the story begins with
women who cannot sympathetically relate to their social and geographical environs, and it traces
their education about how to find their appropriate “seat” and how to function healthily and
happily as a part of a larger communal whole. They learn epistemic values that show them how
to interpret the past, present, and future. And their final cure is a wedding.

44
Miriam Bailin has noted: “sickness and the nursing of sickness, in the home or among the
neighboring poor, were two primary modes of self-expression and activity available to women of
the middle and upper classes” (26-7). While both being ill and caring for the ill were acceptable
female roles, the latter was a much more sought after characteristic in a prospective wife; “the
care of the sick [was] one of the primary duties and supposedly instinctive capacities of the angel
in the house” (11) While nurses were expected to be more nurturing and maternal than their
physician counterparts, they both generally agreed on basic tenets of medicine, such as the
importance of monitoring symptoms and subsequently employing treatment in order to gain
health. Nurses (both professional and familial) had long been expected to rely on attentive
examination in order to care for their patients. Unlike doctors, who had relied on medical
knowledge and theories in the past, nurses had minimal training besides the use of their senses.
Moreover, nurses were depended on to note and act upon symptoms with much more frequency,
due to their continual presence at the patient’s bedside.

50
But while Elinor’s and Marianne’s story might end here, the story of sympathy does not.
The following chapters discuss other novels that are equally shaped by sympathy. Despite
consisting of different genres, focusing on different classes, and telling different plots, each of
the following novels shares with Sense and Sensibility the idea that the smallest part of an
individual body reflects in miniature, like Austen’s two inches of ivory, an entire community
united in either sickness or in health. While Shelley, Martineau, and Barton may not pen the
same iconic style as Austen, they, too, will reflect on the efficacy of the epistemic values that she
promotes in order to make sense of the sympathetic worlds they create.

51
Chapter Two:
The Shape of Disease in The Last Man
If Austen’s Sense and Sensibility is an education in the epistemic virtues that facilitate
health, then Shelley’s The Last Man is a reflection on the power of disease in the face of all
virtue, moral or epistemic. In a journal entry during what Mary Shelley describes as “the second
year after 1822,” she writes: “Now my mind is a blank – a gulph filled with formless mist – The
last man! Yes I may well describe that solitary being’s feelings, feeling myself as the last relic of
a beloved race, my companions, extinct before me –” (476-7). She writes this after the death of
three children, many friends, and most importantly, her husband. Percy Bysshe Shelley’s
drowning in 1822 seemed to stop time, trapping her in a landscape filled with mist.
The formless mist coalesced into her novel, The Last Man, which portrays her personal
experience writ large. It traces the life of Lionel Verney, the sole surviving victim of a plague, as
he watches his loved ones, his nation, and finally the entire human race suffer and die around
him. Shelley’s mist fills every crevice of the setting, taking the properties of a noxious miasma:
bad air recreates her suffering as it moves from person to person bringing the stillness of death.
Time slows and history seems to end as Lionel wanders a contaminated landscape in which there
is no “remaining particle of futurity” (262). For Lionel, as for Shelley herself, time no longer has
meaning. But space, stretching endlessly before them, is filled with the reminders of disease and
mortality.
Shelley’s transfiguration of her mental anguish into a pandemic relies on theories of
Romantic medicine, which give Shelley an unconventional way to conceptualize and narrate
time and space. As portrayed in Sense and Sensibility, the chronology of events that led to
infection, sickness, and death were murky. Without a clear chain of cause and effect to explain

52
the progression of disease, medical narratives turned from chronological descriptions of the
movement of disease through time to spatial descriptions of the location and internal expansion
of disease. Organs, bodies, and communities were all intimately connected through sympathy.
Because it was frequently thought to be instantaneous, sympathy spread through space rather
than time, sometimes dangerously infecting entire biological or social systems.
45
Thinking
sympathetically, Romantics often perceived the world as both infecting and reflecting the
individual. While Austen focused on the sympathetic interaction between two young girls, their
nerves, and their local communities, Shelley expands this interaction to include the entire globe,
which magnifies and interrogates its author’s own individual suffering. Her novel, like Austen’s,
carefully employs contemporary medical theories about the connection between biological
sympathy and contagious disease to consider seriously how suffering inhabits space.
The sympathy of The Last Man maps hope and despair across global and anatomical
geographies, always presupposing a correspondence between macrocosmic and microcosmic
spaces.
46
As Shelley channels her own sense of loss through the experiences of Lionel, she

45
Speaking of the effects of sympathy in 1836, Dr. George Macilwain of Glasgow begins with
what he assumes all will see as an incontrovertible fact: the “disturbance of these parts (nervous
system, digestive organs, skin, and lungs) generally takes place simultaneously; or that to
whichever one of them the injurious influence may have been first addressed, that some one of
the others, and commonly all, very speedily manifest a greater or less participation in the
disturbance” (122).

46
Modern affect theory inherits many characteristics of Romantic theories of sympathy,
especially the branch of affect theory that attempts “to unfold regimes of expressivity that are
tied… to resonant worldings and diffusions of feeling/passions – often including atmospheres of
sociality, crowd behaviors, contagions of feeling, [and] matters of belonging.” Affect theory
attempts to describe what many Romantics would have recognized as sympathy: “The ebbs and
swells of intensities that pass between ‘bodies’ (bodies defined not by an outer skin-envelope or
other surface boundary but by their potential to reciprocate or co-participate in the passages of
affect [or sympathy])” (Siegworth 2). Both affect theory and the theory of sympathy emphasize
“body-to-body/world-body mutual imbrication” (13). Thus, affect theory is a useful lens for
thinking about the personal and political relationships present in The Last Man.

53
creates a world that that both reflects and creates her protagonist’s trauma. However, as she
translates individual despair onto the world stage, it takes on political, cultural, and racial
dimensions that far exceed her personal grief. Lionel’s individual suffering intertwines with the
global suffering from the fictional plague of the novel, which threatens the boundaries of both
Europe and the white European body much as its non-fictional counterpart, cholera, does.
Seemingly an emanation of what affect and race scholars, Fred Moten and Stefano Harvey, have
called the “self-defense of the surround” in response to colonization and slavery, the plague is
both exterior, emanating from a space that is racially and culturally other, and interior, reflecting
the inner turmoil of both Shelley and Lionel (65). Shelley uses medical models of sympathy to
portray the contradictory impulses that occur when a suffering white body encounters the
suffering of the racial other. As time and history grind to a halt, space is disconcertingly
reconfigured by the shrinking geographical distances between Black and white bodies, which
threaten the cohesion of white identity even as it reinforces its sovereignty.
Sympathy: The Part and the Whole
Although Mary Shelley’s The Last Man has recently attracted scholarly attention and
praise, its initial reception was scathing perhaps due to what the Monthly Review described as the
author’s “departure from all the acknowledged canons of inventive literature,” and her morbid
subject matter (“Review of The Last Man” 333). Yet her contemporary critics and more modern
scholars agree on one fact: Mary Shelley knew disease.
47
The Monthly Review continued: “It is
not a picture which she gives us, but a lecture in anatomy, in which every part of the human
frame is laid bare to the eye, in its most putrid state of corruption” (335). The similarities

47
In our own century, Anne McWhir notes that “Shelley knew both the medical theory of her
day and the discourse of disease that permeates revolutionary and Romantic texts” (2); similarly,
Peter Melville writes, “By all accounts, Shelley was well versed in the medical theories of her
day” (831).

54
between Shelley’s novel and an anatomy lecture go beyond the sometimes graphic or clinical
descriptions of disease to which the Review objects and extend to the way it describes the time
and space of disease. As the chronology of her story breaks down and hope for the future
becomes a relic of the past, she increasingly relies on creating a geographical narrative in which
individual and global events correspond in order to create a coherent story.
Shelley’s depiction of space depends upon the rhetorics of sympathy, miasma, and
contagion. Speculation about the origins of diseases and the exact mechanisms through which
they infected the body often became a heated subject in medical journals, particularly in the form
of the “contagion debates” during the early decades of the nineteenth century. These debates
usually centered around whether the disease-causing agent was contagious or atmospheric.
48

While physicians generally accepted small pox, measles, and scarlet fever as contagious,
diseases such as cholera, typhus (or typhoid), malaria, influenza, and those generally
denominated as “fever,” were hotly contested. Yet, while such arguments disputed the
definitions of terms such as “infectious,” “contagious,” and “epidemic,” most physicians, as well
as much of the public, believed some version of what Dr. A. Brigham described in a treatise on
disease in 1832 as “the doctrine of contingent contagion,” which theorized that:
although the disease arises from some aerial or terrestrial influence, of which we
at present know nothing, and over which we have no control, yet in the filthy
hovels of the indigent, in the impure air of crowded apartments, the disease may,
and sometimes does acquire a character of communicability, which it did not at
first possess, and of which it is deprived, when these circumstances are not

48
For a prominent example of anti-contagionism, see: Dr. Charles Maclean’s Results of an
Investigation Respecting Epidemic and Pestilential Diseases (1817). Dr. Thomas Bateman’s A
Succinct Account of the Contagious Fever of this Country (1818) adopts a contagionist stance
and includes a rebuttal to Maclean on pages12-14.

55
present, or when it occurs in well ventilated and cleanly situations. (296)
Epidemic and endemic diseases could therefore be primarily miasmatic, but still occasionally
contagious given certain situations. Or as Dr. Brown similarly observes during the cholera
outbreak in 1832, “it is surely neither inconsistent with medical history in general, nor with that
of this particular malady [cholera], that a disease originally possessing no contagious or epidemic
powers may acquire it; a fact which is well known to the profession to occur” (11). Even for
proponents of miasma theory such as Shelley, then, occasional transmissions of disease through
human effluvia were thought to be possible. The contingency of contagion makes possible the
correspondence between the global phenomena of a disease that traverses continents upon air
currents and the individual intimacy of suffering that may be passed from lips to lips, reinforcing
the larger Romantic tenet dictated by sympathy that biological life instantaneously and
reciprocally adjusts across microcosmic and macrocosmic systems.
Like many Romantics, Shelley followed Adam Smith and other Scottish Enlightenment
philosophers by extolling the positive ramifications of sympathy, believing that “to feel much for
others and little for ourselves …constitutes the perfection of human nature” (Smith 43-4). She
describes Adrian, the most virtuous character in The Last Man and Lionel Verney’s closest
friend, as feeling that “he made a part of a great whole. He owned affinity not only with
mankind, but all nature was akin to him; the mountains and sky were his friends; the winds of
heaven and the offspring of earth his playmates; while he the focus only of this mighty mirror,
felt his life mingle with the universe of existence. His soul was sympathy, and dedicated to the
worship of beauty and excellence” (45). Through his philosophy of benevolent sympathy, Adrian
becomes the most effective (although ultimately unsuccessful) figure in battling the global
epidemic that destroys the population because he “can bring patience, and sympathy, and such

56
aid as art affords, to the bed of disease” (247). In other words, the extraordinary sympathy he has
for other people allows him to care best for the society as a whole.
Yet, the healthy kind of sympathy that promotes compassion is only one kind of
sympathy that appears in the novel. As we have already seen in Chapter 1, the sympathy of the
early nineteenth century transmits feelings and sensations of all kinds and did not always result
in the compassion that is commonly associated with sympathy today. Pain or sickness could be
transmitted from person to person, causing the receiver to experience feelings of horror or
symptoms of disease as often as it caused feelings of compassion or pity. Sympathy was not
always an “agent of equilibrium and solidarity” but also a “ transmitter of disorder” (Fairclough
37). The sympathy of disorder not only communicates symptoms from part to distant part in a
diseased body but also communicates disease from person to person, serving, in the words of
Jennifer Deren, “as a carrier of fear, grief, and disgust as well as compassion, good will, and
peace” (154). Although Deren does not fully acknowledge the biological foundations of what she
terms “revolting sympathy,” it, even more than its healthier counterpart, had a long history of
literal and metaphorical association with epidemic disease (135). Hume wrote in 1748 that “[t]he
passions are so contagious, that they pass with the greatest facility from one person to another,
and produce correspondent movements in all human breasts” (906). Nearly one hundred years
later, Thomas De Quincey penned a similar sentiment: “Many a man has been drawn, by the
contagion of sympathy with his own class acting as a mob, into outrages of destruction or
spoliation, such as he could never have contemplated with toleration in his solitary hours” (209).
Because it linked the symptoms of a part of the body with the wellbeing of the
community as a whole, sympathy was particularly conducive to examining contagion,
which ravaged bodies and communities in tandem. Sympathy rendered epidemics more legible

57
and as a result, epidemic and infectious diseases became an area of intense scrutiny for
physicians who often attributed their spread to sympathy, miasmatic, and contagious
mechanisms working together, operating both inside and between bodies. During England’s first
cholera outbreak in 1831-2, Alexander Fyfe, a surgeon, warns against the dangers of fear that
rise out of too much sympathy with the afflicted: “nothing is so well fitted to bring on any given
complaint, other circumstances favouring, as fear. To this as a cause, I presume we may very
warrentably [sic] attribute thousands of cases of Cholera, -- for fear of itself, will give rise to a
very severe bowel complaint and sympathy will make a man vomit or even feel spasms and
cramps” (19). In this case, sympathy (in the social sense) with sick community members could
actually travel through the nervous system to cause sympathy (in the medical sense) between the
brain and the stomach. Fyfe’s warning echoes that of Adam Smith, who had reflected a similar
understanding of sympathy in The Theory of Moral Sentiments (1759): “Persons of delicate
fibres and a weak constitution of body, complain that in looking on the sores and ulcers which
are exposed by beggars in the streets, they are apt to feel an itching or uneasy sensation in the
corresponding parts of their own bodies” (4). Despite the many changes in medicine between
Smith and Fyfe, the role of sympathy in transmitting disease remains constant and shows the
enduring way that sympathy was thought to carry information between individuals and between
individual body parts.
Shelley exemplifies this medico-philosophical analogy by elaborating the literal and
metaphorical imbrication of sympathy and the plague. In several cases in her novel, sympathy
literally becomes, in addition to miasma and contagion, a mode of transmission of the plague.
When a deranged preacher begins describing “with minute detail, the effects of the plague on the
human frame” he causes a listening peasant to die purely from sympathetic fear: “[The preacher]

58
looked on the peasant, who began to tremble, while he still gazed; his knees knocked together;
his teeth chattered. He at last fell down in convulsions. ‘That man has the plague,’ said the
maniac calmly. A shriek burst from the lips of the poor wretch; and then sudden motionlessness
came over him; it was manifest to all that he was dead” (264). This anecdote suggests not simply
that sympathy works in ways analogical to pestilence but that sympathy itself can become a form
of pestilence, killing not through miasma or contagious effluvia, but directly through the nervous
system. As Deren notes, “most of the characters closest to Lionel suffer and die from
complications of sympathy” rather than the literal plague (150). She points out that the deaths of
Evadne Zaimi, Lord Raymond, Perdita, Idris, Clara, and Adrian all come about, at least in part,
through an excess of a desire to identify with others, causing grief, fear, and clouded judgment.
For Romantics, the transmission of contagion depended on sympathetic mechanisms
within the body. Conversely, sympathy between bodies depended on contagious transmission.
When a self-appointed preacher begins to convert and oppress the dwindling population
travelling with Adrian and Lionel, he does so primarily through sympathetic processes.
Fairclough notes that during the Romantic period, particularly in the case of “audiences
addressed by an orator… a contagious transmission of emotion and opinion seems to occur”
suggesting “that a material process of [sympathetic] transmission is actually taking place” (60).
Through this process, Shelley’s preacher converts the crowd and “such was the power of
assertions, however false, yet vehemently iterated, over the ready credulity of the ignorant and
fearful, that [his apostles] seldom failed in drawing over to their party some from among our
numbers” (386). The preacher’s destructive powers of sympathy make him yet another form of
plague surrounded by a “pestilential atmosphere which adhered to his demoniac nature” (393).
The concepts of contagion and sympathy were deeply imbricated, working together on both

59
physiological and metaphorical registers to create a narrative about how disease traveled through
space.
Global Sympathies
The Last Man shifts uneasily from embracing the productive potential of universal
sympathy to fearing its capacity to destroy life and identity. On a global level, this shift reflects
the ambiguous position that the novel holds towards the globalizing forces of colonialism and the
slave trade that shape both Shelley’s nineteenth-century England and the novel’s futuristic
version. The beginning lines of the first chapter establish Lionel’s England as paradoxically in
sympathy with the rest of the world but also as the most influential within that sympathetic
system: “I am the native of [what] appears only as an inconsiderable speck in the immense
whole; and yet, when balanced in the scale of mental power, far outweighed countries of larger
extent and more numerous population” (9). Lionel embraces a vision of global sympathy but
only with England as the focal point – the localized part that emanates sympathy outwards.
Lionel’s vision is a philanthropic one shared with Adrian who dedicates “all of intellect and
strength that remains to me, to that one work… of bestowing blessings on my fellow-men!” (76).
However, such philanthropy, as eulogized as it might be within the novel, is inseparable from
colonial paternalism.
When Adrian goes to war against the Turks, he observes, “The Turks are men; each fibre,
each limb is as feeling as our own, and every spasm, be it mental or bodily, is as truly felt in a
Turk’s heart and brain, as in a Greek’s… Think you, amidst the shrieks of violated innocence
and helpless infancy, I did not feel in every nerve the cry of a fellow being?” (161). The pain
that is felt by Turkish limbs during the violence of war is communicated to Turkish brains and
hearts through the nervous system is also communicated through sympathy to Adrian’s nerves

60
and to his brain and heart. This beneficial sympathy works to bring people, communities, and
nations together in the hope of mutual wellbeing and the prevention of war. But this utopian goal
is brought back down to earth by the reality that Adrian is, nevertheless, engaged in killing the
Turks, an activity which he believes to be necessary despite his avowed sympathies. Unifying
mankind apparently requires the sacrifice of a few who just happen to be of a different religion
and situated on the interstices of European identity. The hypocrisy of Adrian’s sympathetic
vision resembles the racialized double-vision later noted by Frantz Fanon, who writes that: “Man
is a ‘yes’ resonating from cosmic harmonies” and yet notes that “a Black is not a man” (xii). The
Turks, like Fanon’s Black man, must either be removed from cosmic harmony or held in
subjugation to it; the Turk and the Black man can receive sympathetic resonance, but their
contributions to it cannot be acknowledged with anything other than sentimental regret.
49

Adrian’s sympathy is a productive one; it seeks to build a “paradise” free from suffering where
“each man might find a brother in his fellow,” but it resolutely overlooks the destruction that
must accompany such productive labor. It is a blind, white, and Euro-centric “yes.”
The plague is the materialization, to inflect Fanon’s phrase, of “a ‘no’ resonating from
cosmic harmonies.” Much like Adrian’s vision, the plague unites the globe in sympathy. It
“mingled with the atmosphere, which as a cloak enwraps all our fellow-creatures – the
inhabitants of native Europe – the luxurious Asiatic – the swarthy African and free American had
been vanquished and destroyed by her” (426). Yet unlike Adrian’s vision, the sympathy of the
plague moves inwards from what Moten and Harney have called the “surround” or “the common

49
Both the Blacks and the Turks in the novel serve predominantly as the racial and cultural other
against which white Europe defines itself, and therefore, Fanon’s work is useful in this context to
speak about otherness not limited to Blackness. However, as we shall see, Blackness still holds a
particular meaning of negation that should not be conflated with different kinds of otherness.

61
beyond and beneath,” towards England visualized as the center (8). The plague comes from
foreign and racialized spaces. It evokes the uneasy sympathetic exchange of disease associated
with the encounter between the self and racial or national otherness in a way that is metaphorical
as well as literal and compatible with contemporary theories of medicine. Far from the
benevolent sympathy that Adrian claims will unite the world in health and understanding, this
type of sympathy spreads contagion and disease and emphasizes the danger of foreignness.
Moreover, it reflected concerns about the spread of cholera, whose approach was already
threatening England’s shores by 1826.
Shelley’s novel explores the role of air currents in spreading cholera to Europe in a
transgression of racial and national divisions. While cholera would not infect the shores of
England until five years after The Last Man’s publication, it was already a growing concern for
the British, who had already experienced its devastating effects in India and were watching it
creep closer and closer along major trading routes. While Shelley was writing The Last Man, The
Lancet published a dire warning about cholera’s spread, which had reached the borders of
Europe and The Lancet’s attention by January of 1825. After tracing its growth to the borders of
the Caspian Sea, the article concludes:
It is true that it did not absolutely make its appearance in Europe, but it reached to the
very borders; and as it was only arrested by the commencement of the cold weather, it is
not improbable but that it may again break out in the returning summer; it therefore
becomes the local authorities most energetically to take such measures as may avert the
scourge which threatens the Russian population, and consequently all Europe. (“Analysis
of Foreign Medical Journals” 471)

62
Shelley’s plague traces much of the same route as outlined in The Lancet and mirrors cholera’s
symptoms as well as its geographical spread, including the characteristic “nearly black” skin of
its corpses (217).
50

Slavery and colonialism created a British ideology of positive sympathy, adopted in
Shelley’s novel by Adrian, that justified colonization and slavery in the name of “blunting the
arrows of death, soothing the bed of disease, and wiping away the tears of agony” across the
globe (The Last Man 76).
51
Shelley’s plague, like its non-fictional counterpart, imaginatively
becomes the reciprocal negative sympathy that represents an invasion of the West by the East
and the South as the foreign disease spreads across the English countryside; it begins on the
“shores of the Nile” and effects “parts of Asia” and Constantinople before traveling throughout
Europe and eventually to the British Isles (175).
52
The plague brings a form of sympathy akin to
what Fred Moten and Stefano Harney call “hapticality,” a form of love that they associate with
the slave trade. Writing about the descendants of slaves whom they describes as “outlawed,
interdicted, intimate things of the hold, containerized contagion,” Moten and Harney reflect:

50
For others who have discussed the similarities between cholera and Shelley’s plague, see
Paley’s introduction (xiii) and Fuson Wang’s “Romantic Disease Discourse” (473). For a
detailed analysis of how the black skin of cholera victims contributed to a racialized discourse
about cholera, see Erin O’Connor, Raw Materials, chapter 1.

51
As Erin O’Connor notes: “[Cholera] provided a figure for the threatening fluidity of cultural
and bodily boundaries in an imperialist world economy” (10). Slavery and colonialism had
already broken such boundaries in the name of progress. Although the slave trade was officially
abolished in England in 1807, the plantation slavery continued to thrive in British colonies while
Shelley wrote her novel and remained key to Britain’s colonial empire.

52
Noting that the only change in technology that marks the novel as set in the far future is the
advent of balloon travel, Siobhan Carroll remarks that because aeronautical views “display no
human-drawn borders, such views reveal a nation laid open to the world. To envision the nation
from the perspective of the atmosphere is thus also to reflect on the nation’s connectedness to the
space of the global and, for many British authors, to envision the nation as vulnerable to foreign
invasion, international competition, and cosmopolitan dissolution” (125).

63
“Never being on the right side of the Atlantic is an unsettled feeling, the feeling of a thing that
unsettles with other.” Yet, the very distance from the “settled,” from the white colonizer and
enslaver, is belied by an unsettling intimacy. Hapticality is “modernity’s insurgent feel, its
inherited caress, its skin talk, tongue touch breath speech, hand laugh. This is the feel that no
individual can stand, and no state abide” (38). By shrinking the geographical distances between
Black and white bodies through colonialism and the slave trade, England invited a form of
sympathy that it did not expect. This “revolting sympathy” is indeed a revolt, a reclamation of
the white settler’s production by the sympathy of the surround and from the “zone of nonbeing,”
or the “existential deviation” imposed on the racial other by “White civilization and European
culture” (Fanon xii, xviii).
Bodily Sympathies
The outward global manifestations of sympathy align most explicitly with inward
corporeal manifestations during Lionel’s encounter with the “negro half clad” whom he stumbles
over as he races to see his dying child:
It was quite dark; but, as I stept within, a pernicious scent assailed my senses,
producing sickening qualms, which made their way to my very heart, while I felt
my leg clasped, and a groan repeated by the person that held me. I lowered my
lamp, and saw a negro half clad, writhing under the agony of disease, while he
held me with a convulsive grasp. With mixed horror and impatience I strove to
disengage myself, and fell on the sufferer, he wound his naked festering arms
round me, his face was close to mine, and his breath, death-laden, entered my
vitals… I sprung up, threw the wretch from me, and darting up the staircase,
entered the chamber usually inhabited by my family. (366-7).

64
Soon after this scene, Lionel himself falls ill with the plague from which he, unlike any other
infected person, recovers. This scene has garnered much attention for three reasons. First, the
description of the black man’s “death-laden” breath infecting Lionel has been misread by some
as creating a “paradox” when compared with the novel’s assertions elsewhere that the plague
“was not what is commonly called contagious” but rather was “epidemic” (The Last Man 231).
Such critics posit a binary relationship between contagion and epidemic (or miasmatic) diseases
that ignores the nuances of contingent contagionism discussed earlier in the chapter.
53
Second, it
is the event that appears to cause Lionel’s infection and singular recovery. And third, it is the
only moment in the novel in which Lionel encounters a person of color. Perhaps unsurprisingly,
these last two details are related. Almost certainly a descendant of the slave trade, the “negro half
clad” is the fulcrum of an elaborate metaphor as well as a scientific phenomenon. His contagion
is both literal and symbolic of the uncomfortable intimacy produced by the relationship between

53
For examples of scholars who, in spite of the contingent contagionism common during
Shelley’s time, view this scene as an etiological paradox, see Siobhan Carrol, “Mary Shelley’s
Global Atmosphere,” European Romantic Review, 25, no. 1, 4 and Peter Melville, “The Problem
of Immunity in The Last Man,” Studies in English Literature, 1500-1900, 7 no. 4, 826. Mellville
makes the distinction (which was noted by many 19th century physicians) between contagion
that is perpetuated by “the exhaled breath of a given sufferer” and the miasmata caused by “not
just one body but a number of diseased bodies ‘crowded’ together in places such as ‘hospitals,
jails, [and] transport ships,’” explaining that the latter is “an atmosphere of stagnation in which
diseased bodies are subject to putridity that eventually renders the air infectious to those who
would visit the sick in such places.” While this is an important distinction, it is not one that can
shed much light on Lionel’s encounter since he seems to be exposed both to the “pernicious
scent” of the room and the “death-laden” breath of the sick man. Melville rightly concludes that
“Lionel will never know how he becomes ill” (833-4). Nor, despite Peter Melville’s claims that
Lionel is “uniquely exposed to the plague in this manner,” is this the only instance of contagion
in the novel (826). Earlier, an old woman is seized by a plague sufferer and forced by his grip to
spend a night in his company: “Morning broke; and the old woman saw the corpse, marked with
the fatal disease, close to her; her wrist was livid with the hold loosened by death. She felt struck
by the plague; her aged frame was unable to bear her away with sufficient speed.” (288). For a
more nuanced look at Shelley’s representation of disease, see also Anne McWhir, “Mary
Shelley’s Anti-Contagionism: The Last Man as ‘Fatal Narrative,’” A Journal for the
Interdisciplinary Study of Literature, 35, no. 2.

65
the descendants of slaveholders and slaves. Unlike other encounters, here Lionel does not give
the other person a name: he is just a “negro” and a “wretch,” and never once a man; Lionel views
him only as an impediment in his rush to see his dying son, showing no remorse in “throwing”
the man from him in an act of violence unlike the behavior he has hitherto shown towards other
plague victims. But reading this scene in terms of disease theory offers another version of this
encounter, one symptomatic not just of cultural difference but also of a trans-cultural form of
sympathy based on contingent contagion and the sympathetic nature of disease as an organic
force. Far from being a scene of pure objectification, it reveals the cultural and racial aspects of
the plague precisely through its accurate representation of current understandings of disease and
the sympathetic intimacy of the encounter.
Several scholars have interpreted Lionel’s encounter with the “negro half clad” as an
inoculation that makes Lionel immune to the plague. Anne K. Mellor suggests that “if one were
forced to embrace the Other rather than permitted to define it exclusively as ‘foreign’ and
‘diseased,’ one might escape this … plague” (24). Fuson Wang similarly reads the encounter as
an inoculation, and he also rightly interprets it as a missed opportunity: “Ever since he forcefully
‘threw the wretch’ from his body – rather than actively fostering an experiment with
cosmopolitan community to cope with the annihilation of the plague – Lionel experiences
nothing but loss and degradation” (474). Wang’s reading appears the best way to interpret
Lionel’s otherwise unexplainable recovery from the plague; his brief encounter with the alterity
of the racialized other inoculates him against the mortal threat of the related, but amorphous,
alterity of the plague. But if this inoculation occurs, it must be understood, like the larger

66
phenomenon of the plague, in terms of excess sympathy -- not the kind that brings communities
together but the kind that communicates disease.
54

Lionel absorbs the Black man’s breath, forcing Lionel to share his symptoms. But even
before that breath can cause infection, Lionel instantaneously experiences the “sickening
qualms” from which the “negro half clad” is suffering in a moment of involuntary sympathy
caused by the sensory stimuli of the Black man’s clasp around his legs, his repeated groan, and
his pernicious scent, which travel through the nerves to Lionel’s heart. As Deren argues, that
very connection of Lionel’s “repulses him from the fellow human in need even as it pulls him
closer” and “sympathy exceeds the expectations of both participants” (145). In this sense, the
scene anticipates the nausea, a visceral sickness accompanied by hemorrhage, that Franz Fanon
associates with the experience of objectification in the face of white hegemony. But the nausea
occurs in the face (literally) of a recognition not of difference but shared humanity. Frantz
Fanon’s describes an experience on a train over a century later when a little boy cries, “Look! A
Negro!” Fanon recounts:
I was no longer enjoying myself. I was unable to discover the feverish coordinates of the
world. I existed in triple: I was taking up room. I approached the Other… and the Other,
evasive, hostile, but not opaque, transparent and absent, vanished. Nausea. I was
responsible not only for my body but also for my race and ancestors… what did this
mean to me? Peeling, stripping my skin, causing a hemorrhage that left congealed black
blood all over my body. (89, 92).

54
My interpretation challenges Peter Melville’s, which not only rejects altogether the idea that
Lionel’s immunity stems from his experience with the Black man but also reads Lionel’s
behavior as “a lapse in precisely the kind of sympathy toward sufferers of which he routinely
preaches to others in the community” (835).

67
Fanon’s encounter depicts a burden foisted on him by white hegemony – the burden of
accountability for his entire race. Further, this accountability is depicted as a nausea and
hemorrhage that may well be called “the agony of disease.” I suggest we read Lionel’s encounter
with the “negro half clad” as a precursor to Fanon’s “Look! A Negro!” The Black man suffers
from nausea and festering hemorrhage: symptoms of the plague but also symbols of the Black
man’s afflictions foisted upon him by white settlement. Perhaps, like Fanon, The Last Man’s
“negro half clad” may have “wanted quite simply to be a man among men… would have liked to
enter our world young and sleek, a world we could build together” (92). Denied the ability to
participate in a positive, world-building kind of sympathy, he must embody instead its
negation.
55
The plague’s insidious power is the opportunity to sympathetically share the
symbolic and literal suffering of the Black body.
Lionel involuntarily shares in the nausea and the agony of the Black man as their two
breaths become one when “his breath, death-laden, entered [Lionel’s] vitals.” In other words, the
Black man confronts Lionel with the suffering reality of his subjective pain despite Lionel’s
determination to view him as an object. Deren notes that “the scene shows how the dissolution of
differences that occurs in a sympathetic encounter can constitute involuntary racism: an
instinctive fear of or revulsion from the (racial) other, whose sudden collapse into the
(sympathizing) self is horrifying and inexplicable” (146). The momentary realization that the
Black man is like Lionel himself increases Lionel’s horror, which blends with his own “aching
nausea” that eventually leads to the plague.
56
In this moment of sympathy, Lionel truly feels the

55
“The image of one’s body is solely negation” (Fanon 90).

56
Within the structuring racial logic of the British Empire, Lionel can only choose between a
racist objectification of the Black man or a sympathetic revulsion from the Black man. In either
case, Lionel’s racism is preserved.

68
same sensations that the Black man feels, and it has lasting implications for Lionel, both in terms
of his suffering and his possible inoculation, in spite of his quick return to objectification of the
“wretch.” Objectification does not limit the power of disease.
Sympathy in Time and Space
Lionel’s encounter with the Black man is an instance of synecdoche in which Lionel’s
personal experience encapsulates the concurrent experience of the entire world. The Black man’s
breath, like the global air currents, brings disease and death from spaces marked with racial
alterity. This synecdoche depends upon the mechanisms of sympathy, miasma, and contagion,
which span literal and metaphorical registers within Shelley’s text. This instance is only the most
prominent and most medical of many such synecdoches in the novel, many of which operate on
formal and metaphysical levels. These synecdoches suggest an underlying sympathy between the
individual parts of nature and nature itself that includes medical mechanisms but also transcends
them. Later in the novel, nine hundred remaining survivors in England flee their nation in hopes
of finding a more salubrious locale on the mainland of Europe at the same time that Lionel
fervently hopes that Idris, his wife and one of the nine hundred, is recovering from a deathly
illness (not the plague) brought on by stress. The health of Idris and the health of the larger
community appear to be one and the same to both Idris and Lionel, who writes: “She told me that
she was sure she should recover. That she had a presentiment, that the tide of calamity which
deluged our unhappy race had now turned” (345). Idris’s recovery and the recovery of the whole
race appear linked by the way the two sentences are structured to imply that the latter is merely a
repetition of the former. In the end, the form of the sentences forecasts that the fates of the
individual and the community are indeed metaphysically linked, although not in the way Lionel
hopes. Idris dies before they can depart English shores leaving Lionel to mourn both his wife and

69
his homeland in yet another moment of acute symptoms sympathizing with larger and more
general ones. The rest of the English population, alas, will perish on the mainland soon after.
Such synecdoches illustrate the observation of one of the novels main characters, Lord
Raymond: “Philosophers have called man a microcosm of nature” (66).
Within The Last Man, the plague reigns unchecked across both microcosmic and
macrocosmic spaces. Neither doctor nor government appears to be able even to slow down its
invasion of political and physiological boundaries which continue to erode in tandem. The
plague defies England’s efforts to control it or even to render it legible in either a medical or a
political context. In this respect, the plague again seems a sympathetic precursor to the
hapticality referred to by Moten and Harney as “a feeling, if you ride with it, that produces a
certain distance from the settled, from those who determine themselves in space and time” (38).
The plague appears both everywhere and nowhere in opposition to both doctors, who were
increasingly invested in locating disease in mappable spaces, and settlers, who were invested in
claiming spaces upon the global map.
57
J.B. Harley has noted: “As much as guns and warships,
maps have been the weapons of imperialism. [They] were used to legitimize the reality of
conquest and empire.” (282). If colonialism can be envisioned as a project of mapping – of
making foreignness, racial difference, and disease legible – then the plague is a radical
unmapping. White imperialism dislocates and displaces the racial other in the name of a

57
When cholera infected Great Britain in 1831-2, cartography became an important, although
initially unsuccessful, method for making disease legible. The number of maps included in
medical pamphlets increased greatly throughout the rest of the century, including John Snow’s
now famous map of the Broad Street Pump and surrounding epidemic. However, maps did play a
role in understanding disease prior to cholera reaching the United Kingdom, especially in India.
See Wiliam Scot’s Report on the Epidemic Cholera as it has Appeared in the Territories Subject
to the Presidency of Fort St. George, Madras, 1824. In addition, newspapers like The Lancet had
begun to use the language of mapping and tracing disease across geographical space to talk about
cholera before actual maps of the disease became commonplace. For more on the growing
importance of mapping in the medical field, see Chapter 3.

70
productive sympathy and a mapping of the world; the plague, emanating from the places at the
edge of the map, recalibrates the sympathy between whiteness and blackness by displacing
whites from their homeland as well. It seeks to “destroy and disintegrate the ground on which the
settler stands, the standpoint from which the coloniality and racism emanates” (Moten 52). The
plague’s miasmatic mist produces endless and undifferentiated space, recreating Shelley’s
personal “gulf filled with formless mist” in a global and racial context. Lionel enters into
sympathy with the world but not on the terms he expects. He departs England for the last time
with the scattered remnants of the population in a futile and “bitter, joyless, hopeless pilgrimage”
that alienates him from his homeland in the way that so much of the globe had been alienated by
the British empire (361).
Shelley’s haptic plague defies efforts to fix it in space. It is simply “Here!—everywhere!”
and adheres to only one organizing principle: that inside and outside, large and small, part and
whole, all are connected sympathetically and suffer together (275). Yet it is noteworthy that
Shelley’s characters try to visualize the plague in spatial terms. As the plague enters England,
Lionel “spread[s] the whole earth out as a map before [him]” only to realize that “on no one spot
of its surface could I put my finger and say, here is safety” (260). Nevertheless, the goal of
Lionel, Adrian, and their surviving followers is not to understand better the origins of the plague
in hopes of thereby finding a cure, but rather to find a location in which the plague does not
exist. The story of the plague recounts the struggle to map out legible spaces of health and
prosperity for the white European on global and anatomical levels despite the surrounding plague
that threatens with “absence, darkness, death, things which are not.” (Donne qtd. in Moten 54).
58

The struggle is between a positive and negative form of sympathy that vies to control macro- and

58
Fred Moten quotes John Donne’s poem, “A Nocturnal upon Saint. Lucy’s Day Being the
Shortest Day” (1612?).

71
microcosmic spaces, but it is not a struggle that is chronologically legible. One can map with
certainty which parts of the globe or country have been visited by disease, but one cannot trace
the origins of disease or identify its causes and means of dissemination, whether they be wind or
other atmospheric vectors, contagious travelers, or infected goods.
As we have already seen, thinking about disease in terms of its environment conformed
with the medical epistemology of Shelley’s time, which attempted to explain disease in terms of
particularities of the space it inhabited while professing its own ignorance of how disease
progressed in such spaces. Dr. Sandwith of London remarks in 1835 that “Great obscurity hangs
over the pathology of … disease, simply from not discriminating between the primary and
secondary events in the order of causation” (Remarks on the Theory and Treatment 34). A
timeline of disease could not be created because no one knew which events caused others.
As is the case with an epidemic disease, so too, is the case of Shelley’s novel, which
defies straight-forward accounts of cause and effect that produce a linear chronology. While
narrative must necessarily take place over time, and The Last Man is no exception,
Shelley “often describes temporal matters in spatial terms,” (Rupert 150) such as when Lionel
stands on the shore reflecting that ‘death had hunted us through the course of many months, even
to the narrow strip of time on which we now stood; narrow indeed, and buffeted by storms, was
our footway overhanging the great sea of calamity.’” (371-2). By envisioning the chronological
aspects of disease in spatial terms, Shelley recreates the epistemology of her plague on a formal
level. She describes her plot as events that conform across space while leaving the chronology of
events that she describes uncertain.
The uncertainty of her chronology is most evident in her introduction. The story begins
by taking place in a time similar to that of Shelley’s first readers, when the narrator finds the

72
ensuing narrative in fragments of text written by the prophetic Sibyl two thousand years before
about an event that will happen 250 years in the reader’s future. The story is a translation from
“leaves, bark, and other substances” that “were traced with written characters” from many
different languages, which the narrator claims “owe their present form to me” because they were
“unintelligible in their pristine condition” (5-7). The story is both true and not-yet–true, familiar
and estranged, written by Lionel, the Sybil, and the narrator. Like the content of the novel, its
production is dictated by the white European narrator, but foreign voices emerge insistently in
“ancient Chaldee and Egyption hieroglyphics” (5). The chronological and translational
difficulties of the story encourage both identification with and alienation from the reader, who
wavers between modes of sympathetic emotional connection and aversion in much the same way
that Lionel does when he meets the black man and contracts the plague.
Because the narrator has admitted to considerable liberty in creating a story out of
“unintelligible” scraps, the narrative shows a future constructed from fragments of the past that
may or may not be accurately assembled. Far from creating a “traceable link” between events,
the novel suggests that future events might affect past ones (as when the plague seemingly
generates its own prophetic texts found “later,” which is to say “earlier,” in the Sybil’s cave),
59

just as the “supposed effects” manifesting themselves in certain symptoms seem to “exist before
their causes have developed themselves” in the human body (Omerod 4).
60
These uncertainties
about the structure of the plot mimic one of the central uncertainties of the novel and of the

59
This makes the Sybil’s cave, according to Timothy Ruppert, “a nexus of collapsed time-states,
the cusp at which past, present, and future blend in an extraordinary continuum” that “unsettle[s]
hierarchical, linear understandings of human temporality… and present[s] history as founded
indecisively on disrupted time” (145, 144).

60
Dr. Ormerod writes in 1848, reflecting that cause and effect still remains a problem several
decades after Shelley writes The Last Man.

73
contemporary medical field: “the grand question … of how this epidemic was generated and
increased” (The Last Man 231). Seeking to trace the chain of causality for either disease or novel
will lead only to a dizzying loop – one that the narrator makes clear by finishing the novel with
the same words with which it began: “the LAST MAN” (470).
61

This text does not require the reader to follow the logic of a strict chronology.
Rather, it challenges him or her to join Lionel and the dwindling survivors sympathetically as
they “became ephemera, to whom the interval between the rising and setting sun was as a long
drawn year of common time” (274). The novel encourages the reader to put aside past and future
and elect instead to sympathize fully, even if sometimes revoltingly, with the presence of the
living disease bound within the text. The novel invites an interpretation of its text as, in the
words of Moten and Harney, “a social space [where] stuff is going on: people, things, are
meeting there and interacting, rubbing off one another, brushing against one another – and you
enter into that social space, to try to be part of it.” Lionel’s personal losses and bodily suffering
brush up against and intermingle with global catastrophe, racial injustice, and suffering foreign
bodies. There are no conclusions to be found here but rather an ambivalent reflection on the
potential of “oneness” across the boundaries of identity. The reader may enter with a benign
intention, a desire to “figure out some kind of ethically responsible way to be in that world with
other things,” but there is always the danger of sympathetically imbibing too much of the
diseased body of text and getting lost in the horror of the plague as well (42).
62

On both the microcosmic and the macrocosmic level, Shelley’s novel emanates, in the
words of Anne McWhir, “the effluvium of death” (8). This effluvium takes the form of words.

61
Tarr also notes this characteristic of the novel in “Infection Fiction.”

62
In The Marriage of Minds (2007), Rachel Ablow writes extensively about the relationship
between sympathy and novel reading, albeit in the very different context of marital sympathy.

74
As McWhir notes, the “plague itself enters the novel first as an airborne infection – a word, a
rumour, which has power over people’s minds and imaginations… Words spread like the
diseases they signify” (7). If words transmitted through the air can literally cause the plague, as
in the case of the preacher and the peasant, then the reader, too, is at peril by the sympathetic
power of words transmitted on the page. The experience may not be a pleasant one, but it is a
sympathetic one in which we simultaneously grieve the passing, along with Lionel (and Shelley),
of dear friends and entire nations.

75
Chapter 3:
A “Natural Exhalation” of Rumors in Deerbrook
Like her Romantic predecessors, Harriet Martineau attributes sympathy with a great
power to align people and objects across space. Speaking to the readers of her compilation of
essays, Life in the Sickroom (1844), she writes: “I shall not direct [this book] to your hands, but
trust to the most infallible force in the universe, -- human sympathy, -- to bring these words
under your eye” (xx). She believes that a sympathetic affinity between her prose and the people
who will benefit most from her words will be sufficient to bring them into proximity. Her first
novel, Deerbrook, portrays such sympathy as a powerful biological and moral force that aligns
individual behavior and community values within its eponymous village. The novel unites the
devastating epidemic of Shelley’s The Last Man with the conventional marriage plot of two
sisters found in Austen’s Sense and Sensibility to create a narrative that, like its antecedents,
reveals a sympathetic correspondence between body parts, bodies, and communities.
Martineau does not simply recreate Romantic forms, however. While she retains the
sympathetic models of the past, she also incorporates the burgeoning medical theories of the
present. Her novel reflects the growing dominance of miasma theory in explanations of the
mechanisms of epidemic disease and includes a new focus on the diseases of the poor. In these
respects, Martineau provides what Clayton Tarr calls a “productive, if not sometimes frustrating,
bridge between literary periods
”
and, I argue, also between medical epistemologies (651).
63

Situated between Romantic holism and the rise of the realist novel, and written just after Queen
Victoria ascends to the throne, Deerbrook acts as an intermediary between literary and medical

63
The novel sold only 788 copies in its first year, although it was reissued in 1843, 1858, and
1892, suggesting an enduring, if not immediate, popularity. Charlotte Brontë, Elizabeth Gaskell,
and George Eliot were among its earliest and most admiring readers, however (Sanders xiv).

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movements, showing how sympathetic models of time and space changed in response to new
medical thinking while remaining implicitly embedded in the text.
The Changing State of Medicine
In 1831 cholera first reached the shores of England and left over 20,000 corpses in its
wake, seemingly enacting at least the early parts of Shelley’s prognostications only a few years
before (Johnson 34).
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Although not nearly as deadly as many endemic diseases, it captured the
imagination and dominated the conversation of physician and layman alike with its terrifying
symptoms and foreign mystery (85). The disease primarily, although not exclusively, attacked
poor urban populations, contributing to a shift in the focus of medical concern from the fragile,
nervous bodies of the social elite to the unsanitary and licentious-seeming living conditions of
the impoverished where it would remain throughout the middle decades of the century.
In the wake of the first cholera attack, a senior medical practitioner of Mussleburgh, Dr.
Thomas Brown, writes in 1832 with some ambivalence to the London Board of Health: “There
are not many places that could afford a more ample range for the contagious influence of the
Cholera, than the very great number of our population, which were strongly disposed to suffer
from its contagious effluvia, by their misery, poverty, and vice” (6). While the misery of his
poorest patients might elicit sympathy, their vice inspired condemnation – a sentiment that was
reflected in the Commissioners’ Report of 1834 and the subsequent New Poor Law of 1834. The
commission reasoned that giving relief to the able-bodied poor encouraged vice and idleness and
the New Poor Law was designed to make the living conditions of persons seeking such relief so

64
Steven Johnson depicts the second cholera attack in 1854 in The Ghost Map (2006). Johnson
thoroughly describes the condition of Victorian London both before and during the attack. Also
see Erin O’Connors Chapter 1, “Asiatic Cholera and the Raw Material of Race” in Raw
Material.

77
miserable that any industry would be preferred. Implicit in such reasoning was the idea that the
disease and misery of the poor was a result of vice, and the solution lay in inculcating good
English values.
However, one of the original commissioners, Edwin Chadwick, along with doctors
Thomas Southwood Smith and James Kay Shuttleworth carried out a number of surveys that
showed incontrovertibly that not only did vice and poverty cause disease but also that disease
caused poverty and vice (Bynum 72). In Chadwick’s 1842 Report on the Sanitary Condition of
the Laboring Population of Great Britain, the poor were treated with considerably more
compassion and the key to social reform lay in cleanliness and sanitation. Although the Report
did not immediately produce any substantial results, the returning threat of cholera eventually
spurred the creation of The Public Health Act of 1848, which created a General Board of Health
that included Chadwick (Bynum 77). Even then, the Board faced substantial opposition by those
who resented any centralized authority, and they were able to enact little concrete change until
John Simon replaced Chadwick in 1854. Despite Chadwick’s succession of frustrating failures,
he established a national vantage point from which to understand and observe disease.
The centralization of medicine, as slow and tentative as it was, was aided by the
increasing popularity of statistics, which could take account of large populations in relatively
digestible terms. In 1837, births, marriages, and deaths all began to be registered in civil records,
and statistical societies began to crop up to analyze this newly popularized form of information
(Bynum 65). William Farr, one of Chadwick’s close associates, compiled and evaluated the
nation’s statistics, finding important links between geography, class, age, sex, occupation, and
infectious disease. (Bynum 76) The trends revealed by such statistics articulated disease as not
simply an individual problem but also as a national crisis.

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Chadwick and his associates also contributed to the growing dominance of miasma
theory and its link to poverty in the middle decades. Miasma, physicians reasoned, could easily
explain the prevalence of disease in the lower classes. While miasma could be generated by
rotting vegetation in unhealthy environments such as bogs or humid tropical jungles and carried
along in global air current as seen in The Last Man, it was also increasingly thought to be
generated by “excrementitious matter of every description thrown off from the body, and also by
many other species of filth” (18 Hodgkin). The crowded living conditions, lack of sewage
systems, and poor general sanitation of the urban lower class created the perfect conditions for
the accumulation of miasma. In a lecture for the “working man” given at the Mechanics’
Institution in Spitalfields (a poor section of London) in 1840, Dr. Thomas Hodgkin attempts to
balance compassion with instruction as he warns about the dangers of miasma and the value of
hygiene:
Far be it from me to express, or even to entertain an idea approaching to a want of feeling
for the miseries and privations inseparable from poverty; but I do not hesitate to declare,
from repeated and careful observation, that the habits of too many of the poor promote
and foster various errors of negligence and omission, which not only render poverty more
distressing and degrading, but which also tend to perpetuate it, and at the same time
render it more exposed to the attacks and ravages of disease.” (25)
For Hodgkin, Chadwick, and the majority of the medical community who embraced miasma,
hygiene was the single most important way to defeat disease. Communities may not be able to
alter the atmospheric movements of miasma across the globe, but they could prevent the
accumulation of effluvia generated locally in the slums and factories of British cities. Moreover,
it was incumbent upon the entire community, regardless of class, to address the sanitary needs of

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the poor not only for moral reasons but also because a simple shift in the wind could push the
invisible cloud of miasma away from places like London’s East End into the wealthier
neighborhoods that lay to the West. As Dr. Hodgkin reminds his listeners: “When we consider
how large a portion of the divine moral law relates to our duty to our neighbours, and how much
filthy habits are injurious to them, as well as to ourselves if we unhappily adopt them, we surely
need feel no hesitation in admitting the truth of the remark, that cleanliness is next to godliness”
(19). Keeping a clean home was not adequate protection against disease if it could simply waft
over from one’s poorer and filthier neighbors.
Despite the increasing focus on the dangers of miasmatic effluvia emanating from lower
class bodies and foreign shores, and despite the increasing use of statistics and formulation of a
centralized medical organization, the ways in which medical workers envisioned the time and
space of infectious disease remained substantially the same as in earlier decades. Disease
continued to be a function of corresponding microcosmic and macroscopic spaces connected
through sympathetic mechanisms. Several scholars have argued that theories of biological
sympathy ended with the organicism of the Romantic era. For example, Gigante claims that
The cell theory that transformed life scientific investigation at the end of the 1830s, on
the cusp of the Victorian period, marked an epistemic break with Romantic investigations
into the phenomena of life as such, and in an analogous move literary developments
dispatching the spirit of unity in multeity have done away with the Zeitgeist of
Romanticism as a genuinely cross-disciplinary, transnational approach to living form.
(35)
Similarly, Fairclough claims that the Romantic understanding of sympathy as both biological and
social was “supplanted in the 1830s by new physiological research on reflex action” (229). Yet,

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while such scientific developments certainly did begin to change both medical and literary
thinking, to argue, as Gigante does, that “cellular biology killed off the unifying principle of
Romanticism: the Geist defining both beauty and life” during the 1830s is to collapse a gradual
and incomplete epistemological evolution into a single event that may be convenient to
historians wishing to demarcate between Romantic and Victorian periods but which drastically
oversimplifies this historical shift and undervalues the legacy of Romantic thought that continued
to affect both scientific and literary thinking (36).
Discussions of sympathy remained particularly relevant in relation to infectious disease.
Fever (a term encompassing a wide variety of exogenous as well as some endogenous diseases),
for example, still seemed to operate through sympathetic mechanisms in 1848:
[Fever] is the inference from many symptoms, and the constant recurrence of a series of
them under such various circumstances that they cannot be referred to any single local
disease, which has claimed for them the consideration of independence of the many
ordinary diseases with which they may co-exist, and has placed them as indications of the
existence of an influence on which the local changes themselves depend, which is
modified, indeed, according to the varieties of the local affections, but never more
powerfully assert its superiority to them than in the last struggle for life. (Ormerod 4).
Dr. Ormerod does not explicitly mention sympathy in his treatise on pathological fever; yet,
fever operates within the body through mechanisms that appear remarkably similar to the
universal sympathy of the Romantics, consisting of an “influence” that affects the parts of the
body and transcends such parts in its power and “superiority.” Disease narrative until the 1850s
in both medical texts and in novels retained the earlier Romantic model of envisioning the state
of the whole in instantaneous and reciprocal communication with the parts. Disease was not

81
easily reduced to a single mechanism that caused disfunction but rather was envisioned both in
terms of the entire constitution and in the local lesions simultaneously affecting each other.
On a larger social scale, thinking about the individual in terms of the larger communal
whole continued in a less metaphysical but just as important way after the 1830s due to the rise
of statistics. The widespread use of statistics appeared to make new forms of knowledge
possible. These new forms built on the close observation and attention to detail that had been
increasingly valued during the early decades of the nineteenth century. The use of statistics
configured knowledge in a new way, but it did not challenge objectivity as the arbiter of truth.
Rather, it granted objectivity even more authority in the middle of the century before etiological
speculation and other forms of theoretical knowledge began to gain more traction.
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Without such etiological speculation, physicians of the 1830s and 40s struggled much
like their predecessors to situate infectious disease in terms of time. Fever can be located on the
macro scale of the entire constitution and in the micro scale of local lesions or symptoms, but it
cannot be traced chronologically, as Dr. Ormerod states as late as 1848:
Can we go on and build a rational system of fever, explaining how one organ is first
affected and then another, and tracing all the links to the restoration of health or till the
chain is broken in death? It seems not. We may readily from a tabular analysis shew the
average order of the succession of symptoms; but the more carefully this is done, the
more abundant evidence does it supply of the unsoundness of such a system. At each step
we have frequently to recognize a supposed effect existing before its cause has developed
itself (4).

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For more on the shifting nature of “truth” in science, see Daston, Lorraine and Peter Galison,
Objectivity, and Kennedy, Meegan, Revising the Clinic.

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For Dr. Ormerod, all the statistical tabulation and analysis in the world will not provide a system
that can adequately explain the origins and progression of disease.
Because the chronology of disease remained an enigma and because the logic of
sympathy continued to shape discussions of disease in spite of its waning influence over other
fields of medicine, the dominant chronotope of infectious disease did not significantly alter
during the 1830s and 40s. Rather, the increasing use of statistics opened a new way for doctors
and authors to expand upon the dynamic relationship between individuals and their communities
while the ascendancy of miasma theory reoriented the older chronotope around poor, urban
bodies.
Gossip and the Nervous System
Deerbrook is most indebted to Romantic medicine for its depiction of disordered
sympathy, which frequently takes the form of malicious gossip and drives much of the narrative.
The novel focuses on two sisters, Margaret and Hester Ibbotson, who are newly arrived to
Deerbrook, and Mr. Hope, the village apothecary. Mr. Hope, although initially preferring
Margaret, soon marries Hester with reluctance, leaving Margaret to marry Phillip Enderby in the
culmination of the novel. Mr. Hope’s decision to marry Hester is prompted by neighborhood
gossip that he has led her on with flirtation.
Yet the gossip does not end there. Hope’s neighbors continue to speculate on the
domestic happiness of the family long after his marriage and eventually begin to attack his
medical practice with rumors of graverobbing and malpractice. When the Grey twins, Fanny and
Mary, notice Hester Ibbotson crying as she walks along a village lane, they soon tell Mrs.
Rowland’s daughter, Matilda, who tells her mother who spreads the word that Hester must be
unhappy in her marriage (249-51). Such gossip is harmful precisely because it disrupts “the

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balance between distance and sympathy” which Deborah Fratz has noted is crucial to much of
Martineau’s work (50). In this interaction, the gossipers are guilty of both too much sympathy –
they are overly invested in their neighbor’s affairs – and too little – they do not consider Hester’s
feelings as they perpetuate the rumor.
For contemporary readers, gossip could be a symptom of an underlying nervous disorder
in which the disturbed internal sympathies of the nervous system affect the social sympathies of
the community and vice versa. Martineau’s contemporary, Dr. James Johnson, writes in 1828
about the physiological loop of sympathetic feedback that creates nervous irritability: “[t]he
moral cause [of nervous irritability] makes its first impression on the brain, the organ of the
mind. The organs of digestion are then disturbed sympathetically, and re-act on the brain. And
thus the reciprocal action and re-action of the two systems of organs on each other, produce a
host of effects, moral as well as physical, by which the temper is broken and the health impaired”
(61-2). While Dr. Johnson describes the mechanisms of the disorder as primarily internal and
physiological, he acknowledges that external social factors initiate the sympathetic loop in the
form of a “moral cause” and that, conversely, the internal factors provoke moral effects which
will influence the individual’s external social behavior.
Gossip was sometimes associated with such nervous irritability as both a “moral cause”
and outcome of the disorder. In 1833, R. Fletcher Esq., surgeon to the Gloucester General
Hospital and Lunatic Asylum notes: “The young girls, who… seek relief for the wide range of
symptoms of a nervous kind… will, when they get a little better, and having nothing else to do,
gossip outright, and sometimes, of course, quarrel outright” (21). The surgeon’s notes make it
unclear whether the gossip that disorders the sympathy between the girls is the cause of their

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nervous disorder or the effect, but it is clear that external and internal sympathies correspond,
and Dr. Johnson’s description implies that either scenario of causation could be correct.
Gavin Budge has convincingly claimed that contemporary readers would recognize most
of Deerbrook’s female characters as suffering from nervous irritability induced by the
uneventfulness of village life, which contributes to “a discharge of nervous energy testifying to
an underlying Brononian condition of sthenic understimulation” (125,127). For characters such
as Mrs. Rowland, Mrs. Grey, Sophia Grey, Lady Hunter, Miss Miskin and Mrs. Howell, the lack
of stimulation in their environment sensitizes their nerves to the trivial matters of gossip, which
may then further act as a “moral cause” to disorder their nervous system. In the aforementioned
interaction between Mrs. Rowland and Hester, gossip constitutes a moral dilemma for the
former, who must choose whether to spread it, and for the latter, who must choose how to react
to it. Because of the understimulated state of their nerves, it becomes easier to react in morally
dubious ways by perpetuating gossip and creating a feedback loop of nervous irritability that
involves both the larger community and the women’s individual biological systems.
Moreover, as we have already seen in Marianne’s case in Sense and Sensibility, such
nervous irritability could leave women susceptible to other kinds of disease. As one surgeon, Mr.
Dodd, remarks during the height of the first cholera epidemic in London in 1832: “The
accidental predisposing causes [of cholera] are – grief, watching, fasting, want of cleanliness,
innutricious and irregular diet, the depression which succeeds the excitement from drinking
ardent spirits, utero-gestation, and parturition; in short, whatever produces diminished energy of
the nervous system” (796).
66
The ubiquity of nervous irritability produced by the village lifestyle

66
Gavin Budge has noted: “Martineau follows contemporary medical opinion in suggesting that
the nervous irritability of which Deerbrook’s craving for gossip is symptomatic also represents a
predisposing cause in the deaths of villagers from cholera” (125).

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in Deerbrook partially explains, according to the contemporary mindset, why the plague
devastates the population so badly in the last third of the novel. Gossip and the nervous disorder
that causes it serve as a predisposing cause for epidemic disease.
Martineau, however, emphasizes the role of choice in her depiction of sympathy. If health
in this novel is, as Budge has observed, “an emancipation from the enslavement, through
morbidity, of one’s own nervous system,” then the characters in the novel can remain healthy by
exerting self-control over their manifestation of sympathy, which “channels nervous energies in
the service of a predominant impulse, and so shapes character” (121-2). The importance of such
choices is most readily apparent in the differences between Hester Ibbotson and Mrs. Rowland,
who function as examples of effective and ineffective treatment of their nervous disorders,
respectively.
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The destruction and misery that Mrs. Rowland causes for the Hope family (the
rumors she creates incite a mob to attack Mr. Hope’s house) and the village in general stem from
disease but also from choice, which her husband makes clear when he tells her: “The desire to
get rid of them is a bad symptom, Priscilla, -- a symptom of a malady which neither Hope nor
Mr. Walcot, nor any one but yourself, can cure” (376). Mr. Rowland’s fictional warning echoes
Dr. Johnson’s 1828 medical advice:
I by no means wish to furnish the person thus afflicted [with nervous irritability], with an
excuse for giving way to every impulse of an irritable mind. On the contrary, the moral or
rational curb which he should now endeavor to keep on his temper, ought to be more
forcibly strained than ever. [It is] of the utmost importance, not only to avoid every

67
Budge notes, Hester and Mrs. Rowland “function in Deerbrook as a pair of narrative doubles
which contrast the effects of self-control exercised over an essentially nervous temperament, on
the one hand, and self-abandonment to the destructive impulses of that nervous irritability which
nineteenth-century medical opinion agreed was linked to many female disorders” (123).

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source of moral irritation, but to check the first impulses of irritability, as one of the chief
remedies for the disorder. (62)
Mrs. Rowland’s ability to exert self-control is limited not only by the geography of the village,
which not only offers most women of the middle class the nervous stimulation of prying into
other people’s affairs but also by the pervasive nature of the gossip in the village. Yet,
ultimately, the choice is hers to give in to the predisposing factors that contribute to her disorder.
Deerbrook’s sympathetic connections between internal and external, physical and social,
large and small, are predicated on the Romantic assumption that microcosmic and macrocosmic
networks correspond, which we have already seen depicted in Sense and Sensibility and The Last
Man. Martineau depicts Hester’s individual struggle with nervous irritability as the acute
manifestation of Deerbrook’s larger struggle for health from both gossip and plague. Hester’s
behavior and symptoms ebb and flow in tandem with the well-being of the community. And her
husband, Mr. Hope, is the fulcrum upon which the happy resolution of both Hester’s health and
Deerbrook’s depend. The two crises which the novel promises to, and eventually does resolve,
are synonymous with the two cases which Mr. Hope must cure. The nervous irritability of his
wife, Hester, is the acute and local crisis that Mr. Hope must treat in his domestic space, while
the epidemics (of gossip and plague) raging through the Deerbrook community are a more
general form of malaise that he must treat in the larger public sphere.
Initially, Hester’s story simply serves as a case exemplar of the larger narrative of
nervous irritability and gossip in the village, revealing as Martineau stated elsewhere that “[t]he
mind of a nation [or a village] grows, like that of an individual; and its growth follows somewhat
the same course” (Society in America 301). By depicting Hester as a microcosm of the larger

87
community, Martineau draws on earlier organicist ideas that the part has within it the seeds of
the larger whole.
Mr. Hope treats his community not only by alleviating the symptoms of many of the
villagers suffering from the epidemic but also first by alleviating the symptoms of nervous
irritability by preventing harmful gossip. Philip Enderby says of Hope:
His friends are so attached to him that they confide to him all their own affairs; but they
respect him too much to gossip at large to him of other people’s. I see you do not know
how to credit this; but I assure you, though the inhabitants of Deerbrook are as
accomplished in the arts of gossip as any villagers in England, Hope knows little more
than you do at this moment about who are upon terms and who are not. (38)
Enderby’s comments prove true a few pages later when Hope appears “like a good genius” to
avert the growing animosity between the female members of the Rowland and Grey families
during a social event (40). The party grew “amiable…on his entrance… while Mr. Hope was, to
all appearance, unconscious of the existence of any unpleasant feelings among his neighbours”
(40-1). For Mr. Hope, being a doctor means treating gossip as a symptom of disease. He writes:
“While there is private vice and wretchedness, and domestic misunderstanding, one would desire
to know it, if one can do anything to cure or alleviate it” (96).
A Healthy Crisis
Because Mr. Hope assuages the harmful gossip of the village, he seems primed to cure
Hester as she asks him to do: “you must sustain me – you must cure me –you must do what no
one has ever yet been able to do” (171). Yet as Deerbrook’s gossip epidemic turns literal,
Hester’s relationship with the larger situation proves more complicated. The adversity that
Hester and her husband face first in the form of persecution and poverty stemming from

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malicious gossip and then from the anxiety of being a doctor’s wife during a plague actually help
to cure Hester. After suffering from poverty, Hester’s malady abates temporarily only to return.
Her family remembers that “the infirmity of a life-time was not to be wholly cured in half-a-year;
and that they must expect some recurrence of her old malady at times when there was no
immediate appeal to her magnanimity, and no present cause for anxiety for those in whom she
forgot herself” (497). The anxiety that returns in the form of the literal epidemic, however, along
with the constant care of Mr. Hope, proves to cure her more permanently. She has been
“strengthened” to “conquer the one unhappy tendency from which she had suffered through the
whole of her life” (597).
The literal epidemic, initially seeming to be a more severe manifestation of the
metaphorical one, turns out to have served as a “healthy crisis” that places both Hester and her
community on the road to recovery. Such healthy crises were familiar to physicians of the time.
Dr. Adam Neale, doctor to the Duke of Kent, wrote of cholera in an 1831 treatise animate
contagion: “If by means of [purging] of the alimentary canal, the ‘efficient cause’ or contagion
can be evacuated, without destroying the life of the patient, a healthy crisis takes place ending in
perspiration and sleep” (192 emphasis mine).
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Such healthy crises are often represented in
medical literature as a violent event that affects the sympathetic communication between the
local and constitutional level. While such sympathy prior to the event promotes the worsening of
symptoms by communicating the disease from one level to the other in a downward spiral,
sympathy after the event promotes health because a small local improvement can cause
corresponding constitutional improvements and vice versa. The plot of Deerbrook functions in

68
See also Dr. Meigs speaking about fever in 1824: “we must have a repetition of the paroxysm
…and this again and again, till some new and more perfect crisis restores the balances of the
sanguiferous system, or till death is the consequence of these morbid derangements” (“Review of
Books” 346).

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the same way. The epidemic serves as a healthy crisis that brings out Hester’s best qualities
while minimizing her nervous irritability. After the crisis, Hester’s health emanates outwards; as
her behavior improves, the metaphorical and literal epidemics of Deerbrook improve as well.
The way physicians thought about sick bodies and the way that Martineau thought about her
troubled plot is, crucially, a dynamic one. Not only do local and constitutional conditions reflect
each other but they also affect each other in mutually constitutive ways.
As the epidemic seems to bring about a healthy crisis for Hester, her reformed behavior
conversely seems to set an example of health that assists the village in recovering from its
epidemics. Her loving support of her husband sustains the domestic health of the household even
during persecution and sets an example for others. When the mob roused by gossip surrounds
Mr. Hope as he returns to his house, Hester’s demeanor momentarily assuages their anger:
“When she held out her hand to [Mr. Hope] with a smile as he ascended the steps, the noise of
the crowd was suddenly hushed. They understood rather more of what they saw than of anything
that could be said to them” (356). Later during the literal epidemic, she acts as an example to the
villagers by going to hear the church sermon (despite being a dissenter) in order to, in her own
words, “see clearly what is my duty at a time when claims conflict as they do now” (548). The
sermon reminds her and the other villagers of their “business as nurses and neighbors,” thereby
transforming Hester from the patient she has been through most of the novel to a nurse like her
sister, Margaret, who not only provides care for Hester throughout the novel but also acts as a
nurse for the lower-class villagers during the epidemic.
Hope’s Epistemic Virtues
The description of two sisters -- one who, through self-treatment and nursing others,
easily attains health, and the other who, through poor self-treatment and identification as a

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patient, requires a crisis to attain health – probably feels familiar. Martineau owes much to
Austen’s depiction of Elinore and Marianne Dashwood. The similarities between the two novels
extend beyond the plot trajectories of two siblings and beyond the sympathetic social
connections that influence their world to the way in which the novels deal with time and space.
Both novels not only depict sympathetic relations between microcosmic and macrocosmic spaces
but also propose similar ways of behaving in a world that is so organized – a way of behaving
that coincides with aspects of medical philosophy and extends it far beyond the medical realm. In
Deerbrook, both medical workers, Mr. Hope and Margaret, repeatedly emphasize that one should
deal with situations in the present and let past causes and future resolutions of events take care of
themselves. Such philosophy seems to benefit the general public as well as the medical workers
who first espouse it. When Hester remarks, “I do not exactly see what is to become of us,” Mr.
Hope, and then Margaret replies:
‘Nor do I, love: but is not all the world in the same condition? How much does the
millionaire know of what is to intervene between to-day and his death?’
‘And the laboring classes,’ observed Margaret, -- ‘that prodigious multitude of
toiling, thinking, loving, trusting, beings! How many of them see further than the week
which is coming round? And who spends life to more purpose than some of them? They
toil, they think, they love, they obey, they trust; and who will say that the most secure in
worldly fortune are making a better start for eternity than they? They see duty around
them and God above them; and what more need they see?’ (386).
Mr. Hope and Margaret suggest living in the moment for two reasons. The first resonates with
the biblical overtones of the narrator, who reflects that “the generous and the brave” are those
who “leav[e] the morrow to take care of what concerns it;” in other words, as long as one has

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faith in God, future events will lead to salvation, and therefore worrying about future events is
tantamount to a crisis in faith (494).
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The second reason is that no one, whether millionaire or
laborer, can predict how current and past events will affect the future, and therefore worrying
about the future is an expenditure of energy that should be spent on a better “purpose.”
In this second respect, Margaret’s and Mr. Hope’s philosophy reflects the medical
thinking of the time, which, unable to speculate reliably about the cause of disease or the
mechanisms of its proliferation, primarily focused on treating the signs and symptoms present in
the body or community at a given moment. Martineau’s’ depiction of Mr. Hope’s and Margaret’s
philosophy resonates with the self-described roles of doctors like Dr. Molison, who writes in an
introduction to a pamphlet on the cholera outbreak in 1832 : “My sole purpose is, to furnish
some of the results of the limited experience which I have enjoyed, and which, however
imperfect, has served to afford me information which may not, perhaps, be destitute of
importance. I propose to give an accurate account of the symptoms, such as I observed them, and
of the treatment I found most efficacious” (4). Dr. Molison implies that his “purpose” is best
served by focusing on treating the patients of the present epidemic using his own experience and
observations rather than speculating about the chronology of events leading to disease just as the
“purpose” Margaret imagines for laborers is best served by being “generous and brave” in the
moment and not speculating about how a past chronology of events will develop in the future.
The morality of this philosophy manifests in Mr. Hope’s own forgiving words, “[w]e have only
to do with the present now,” when he compassionately promises to treat Mrs. Rowlands dying
daughter, Matilda, despite Mrs. Rowland’s past transgressions (580). In this affecting scene,

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Matthew 6:34 – “Take therefore no thought for the morrow: for the morrow shall take thought
for the things of itself.” For more about the relation between Martineau’s writing and her
religious convictions, see Catherine Gallagher’s The Industrial Reformation of English Fiction,
1832-1867, Chapter 3.

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Martineau explicitly combines the moral and religious imperatives of forgiveness and faith with
the professional imperative to treat patients based on observation rather than theory and
speculations in order to develop the doctor’s philosophy of remaining in the present.
At the same time that Mr. Hope’s moral and professional philosophy eschews
establishing a chronology of events, it embraces the cataloging of every detail within the given
moment. Such observation is consistent with the importance of empiricism and objectivity
increasingly embraced in the early nineteenth century. Early in the novel, he reveals his expert
mapping skills and his ability to notice detail across distances, if not across time. When Hester
and Margaret desire to explore the area surrounding Deerbrook, the narrator declares, “Mr. Hope
was exactly the right person to consult, as there was no nook, no hamlet, to which his tastes or
his profession had not led him. Sophia put paper before him, on which he was to note distances,
according to his … computations” (17). As a doctor, Mr. Hope is particularly qualified to map
his surroundings due to the wide geographical range of his practice and his keen observational
skills. Furthermore, the skills with which he maps the terrain carry over to his skills in mapping
the body; we learn a few sentences later that his absentminded sketches contain the forms of the
villagers just as often as they do the forms of the landscape.
Once again, Mr. Hope’s proclivities mirror those of many practicing contemporary
physicians, who frequently included maps in their medical articles about epidemics,
documenting distances between affected villages or towns as well as distances between sick
households and privies, dust heaps, water sources, and other objects thought to be correlated with
disease. When doctors did theorize about the mechanisms of disease, such information formed
the basis of their hypotheses. As the surgeon, John Parkin, notes of his own theory on “the
remote cause of epidemic diseases” in 1841: “the facts… that would tend to confirm, or refute,

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the hypothesis now made, must be derived, not from a single locality, but, from various and
distant regions, and from nearly every country, with which we are acquainted” (vii). In other
words, doctors like John Parkin tended to envision disease as mapped across a spatial landscape.
Mr. Hope is not the only Deerbrook character to follow his non-fictional colleagues in
observing the world around him in terms of spatial relations given in the present moment;
Margaret Ibbotson, Maria Young, and the narrator all espouse a similar epistemology. In
contradistinction to such reliable and moral personas, Matilda and the Grey twins belie their
youth and familial propensity to gossip by indulging in speculation about the future. Matilda
continually makes plans about what she will do after she is married even as she lies on her
deathbed (581). The Grey twins enjoy “plots and secrets” that depend upon creating suspense
about what will happen, which leads Maria Young to observe: “I think the love of mystery-
making and surprises goes on as people grow wiser… if they grow really wise, they will find
that, amidst the actual business of life, there is so much more safety, and ease, and blessing in
perfect frankness than in any kind of concealment, that they will give themselves the liberty and
peace of being open as the day-light” (76).
Because narrative is necessarily a temporal unfolding of events, by associating characters
that are virtuous and wise with the desire to isolate the present moment and associating
characters that are ignorant, puerile, or foolish with the desire to see the moment in relationship
to the future, Martineau essentially creates a morality of narratology. In other words, her
characters show us as readers how the novel itself should be read and conceptualized.
Narrating the Present
Deerbrook adopts epistemic virtues similar to those we have already seen in Sense and
Sensibility and both novels come to the same conclusions about how young women should act in

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a world governed by sympathy. However, Martineau uses a very different kind of style to
recount the story of her two fictional protagonists. While Austen’s free and indirect discourse
linguistically performs the sympathetic transfer of sentiment and sensation experienced by her
characters, Martineau’s lengthy monologues perform the epistemic virtue of staying in the
present adopted by both authors’ protagonists.
Deerbrook’s narrator does not often depend on the “pleasures of suspense” to move
forward – pleasures which Caroline Levine reminds us “rely on the act of imagining a future – a
future that, despite our best guesses, may or may not come to pass” and gain more traction later
in the century (9). This kind of imagining is exactly that which Martineau warns against through
her characters and through her prose. In fact, her prose seems to be in no hurry to move forward
at all, as The Edinburgh Review noticed shortly after Deerbrook’s publication: “[Deerbrook] has
little incident, and little variety… The events are few, tame, and trite… She has addressed herself
to thoughtful and patient readers; and has not ministered to that impatient craving after strong
excitement, which is characteristic of too large a portion of the novel-reading public… [T]he plot
of Deerbrook constitutes no prominent portion of its merits” (“Deerbrook” 495-6). If, as Peter
Brooks has suggested, plot constitutes “some combination of Barthes’s two irreversible codes –
those that must be decoded successively, moving in one direction – the proairetic and the
hermeneutic,” then Martineau appears to be resisting both of these codes, avoiding temporality in
the form and content of her novel at the expense, according to the Review, of her plot (18).
The plot frequently pauses while the text records the protracted musings of the narrator or
one of its characters. Consider the opening to the third volume where the narrator goes on for
several pages, completely stalling the chronology of the novel while she reflects on, of course,
time itself:

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The world rolls on, let what will be happening to the individuals that occupy it… [T]he
spirit cannot but be at times overwhelmed by the vast regularity of aggregate existence, --
thrown back upon its faith for support, when it reflects how all things go on as they did
before it became conscious of existence, and how all would go on as now, if it were to die
to-day…as if existence were as mechanical as the clock which told the hours without fail
from the grey steeple.” (417-9)
The fact that the “world rolls on” draws attention to the fact that narrative doesn’t always have
to. The words tell us that time seems inescapable, but for these few pages of musings it is
escapable, at least within the framework of the text. Martineau frequently uses such pauses in
temporality to do much of the moral work of the story. In this case, she once again emphasizes
the importance of religious faith, which makes the forward march of time irrelevant since the
person who has it knows time cannot affect his eternal soul. Thus, the temporary haven from
temporality created by her moral reflection within the narrative promises the permanent haven
from temporality found in faith in salvation.

She suggests that time, or at least our conception of
it, is not as “mechanical as the clock which told the hours without fail” but rather, with the
proper philosophy and faith, malleable – allowing her characters to stay within a given moment
without reflecting on the past or future and allowing her plot to pause for extended
contemplation.
Her suggestion that any individual might “die to-day” foreshadows the many deaths that
will occur from the plague in the latter pages of the novel and underscores the virtue that
Martineau particularly adopts in this extended passage, but which shapes the entire novel – the
precept that “Nothing can crush me, for I am made for eternity. I will do, suffer and enjoy, as my
Father wills: and let the world and life roll on!” (417). Eventually, she does let the fictional

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world of her novel roll on, but her philosophy implies that the forward movement of the plot is
less important than the faith with which she approaches the given moment. In this respect,
Martineau’s moral values align with Mr. Hope’s epistemic virtues and blur the lines between
them; given the body’s (but not the soul’s) susceptibility to disease and death, speculation about
the future is neither spiritually important nor medically possible.
Martineau’s style also distinguishes her from the “conjurors, and fortune-tellers, and
quacks” that precede the plague and, according to Mr. Hope, often “show themselves so
immediately on [an epidemic’s] arrival, and usually before its presence is acknowledged, that
they have often been thought to bring it… they come to take advantage of the first panic of the
inhabitants, where there are enough who are ignorant to make the speculation a good one” (532).
The combination of conjuror, fortune-tellers, and quacks creates a trifecta of bad medical and
moral practices that depend upon trickery and conjecture. As the double meaning of Mr. Hope’s
words suggest, their success hinges upon an accurate speculation about the ignorance of the
townspeople and an inaccurate speculation about the future of those townspeople. The
“prophecies” of the fortune-tellers share a similar epistemology with the gossip of Deerbrook,
which as Kristen A. Pond notes, is antithetical to “the domain of scientific, objective, and
empirical knowledge forms” that Mr. Hope represents and that the narrator relies upon (190).
70

Mr. Hope and the narrator favor minute observation of present facts over the speculation of
fortune tellers and gossips, both of whom the novel denigrates.

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Pond further claims that the text uses gossip to critique the “unbalanced approach to
knowledge” that scientific epistemologies represent. Given the severe censure that gossip usually
receives in the text, however, I find this argument unconvincing (190).

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Miasma, Poverty, and Squalor
Martineau’s style embraces the medico-moral conventions of Romantic medicine, and
her narrative retains much of Romantic medicine’s focus on sensibility and the nervous system.
However, her novel also foreshadows the industrial novel that would become prevalent in the
next few decades by depicting the linkages between poverty, filth, and disease. As an author of
the 1830s, Martineau truly does function as a “bridge” between two eras, showing the similarities
in the ontology of time and space between the two time periods.
Martineau differs from earlier authors in her unquestioning embrace of miasmatic
imagery throughout the novel – a fact that reflects the growing dominance of miasma theory in
both medical circles and in popular opinion. While Shelley and Austen both include miasma
theory to greater and lesser extents, they do so in ways that leave room for contagious
transmission, which reflects the contingent contagionism that was most popular during the early
decades of the nineteenth century. Martineau, on the other hand, adheres strictly to a miasmatic
model that operates in both metaphorical and literal registers. In Valerie Sanders words, “gossip
has functioned as a poisonous miasma in the village, and nothing short of a cleansing purge is
likely to improve its moral outlook” (xxix). This purge comes in the form of the literal epidemic,
but before the real epidemic arrives, “rumours, even the wildest of them, rise ‘by natural
exhalation’ from the nooks and crevices of village life” like marsh effluvia (94). Part of the
reason that Hester finally cures her own nervous irritability appears to be because she and her
sister are “more interested about the natural features of Deerbrook than about its gossip” (37).
The fresh air and beauty of the natural world appear to dispel the effluvia that gossip generates
around the village. Moreover, Hester stays close to her sister, Margaret, about whom Mr. Hope
writes: “The airs of heaven must have been about her from her infancy, to nourish such health of

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the soul” (98). Margaret’s superlative health in both mind and body, caused by the “heavenly”
air around her, seems to combat the miasma of gossip surrounding Deerbrook and to exert a
positive influence on some of Hester’s worse symptoms. Both the metaphorical epidemic of
gossip and the literal epidemic that later ensues in Deerbrook adhere more strictly to miasmatic
models and emphasize the importance of clean and natural air. Even smallpox, which had long
been generally accepted as contagious, appears in the novel to be susceptible to the air’s
influence; Mr. Hope prescribes “only the use of the fresh air that was about her” to a young
smallpox patient as the best treatment (345).
Moreover, it is no coincidence that Mr. Hope treats his smallpox patient at the villages
alms-houses. The increasing importance of working and impoverished bodies accompanied the
ascension of miasma theory throughout the 1830s and 40s. Unlike the genteel scenes of sickness
depicted in Sense and Sensibility or the global miasmas that affect rich and poor alike in The Last
Man, Martineau’s depictions have much more in common with piteous scenes of laboring poor
from later authors like Dickens and Gaskell:
[Mrs. Platt] lay moaning on a bedstead spread with shavings only, and she had no
covering whatever but a blanket worn into a large hole in the middle. The poor woman’s
long hair, unconfined by any cap, strayed about her bare and emaciated shoulders, and
her shrunken hands picked at the blanket incessantly, everything appearing to her
diseased vision covered with black spots. Never before had so squalid an object met
Margaret’s eyes. The husband sat by the empty rate, stooping and shrinking, and looking
at the floor with an idiotic expression of countenance, as appeared through the
handkerchief that was tied over his head. He was just sinking into the fever. (548)

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In this situation, it is the extreme squalor and ineptitude of the lower class that makes them so
susceptible to the plague – a sentiment echoed by Mr. Hope, who reflects: “Indeed, it is difficult
to imagine a place better prepared for destruction than our pretty village is just now, from the
extreme poverty of most of the people, and their ignorance, which renders them unfit to take any
rational care of themselves” (531).
Martineau simultaneously depicts the susceptibility of middle-class bodies to epidemics
through nervous irritability and sympathy and the susceptibility of lower-class bodies to
epidemics through uncleanliness (leading to miasma) and ignorance, reflecting the fact that the
time in which she wrote teetered on the cusp of two major medical foci: miasma and sensibility.
These two medical models for disease were not mutually incompatible nor did they seek to
explain the same phenomena. Both contributed to explanations of epidemic disease, but in terms
of morality, viewing disease in terms of sensibility warned about the dangers of too much
sensitivity and refinement, while viewing disease in terms of miasma warned about the dangers
of moral laxity and filth. In a sense, miasma and sensibility represented two sides of one core
tenet: that morality and physical health were intrinsically connected. During the 1830s and 40s,
the core tenet remained even as medical attention shifted from the dangers of sensibility to the
upper and middle classes to the dangers of miasma to the lower classes.
As the next section will show, the chronotope of Romantic medicine and sympathetic
connections between individuals and communities remained important to certain novels even as
they increasingly focused on the dangers of miasma to lower class bodies (and the dangers of
lower-class bodies to the general public). Industrial novels, in particular, continue to rely on
sympathetic models of time and space even as they lay claim to increasing authorial objectivity

100
by appropriate new medical and scientific vocabularies and focus on the new threats of filth,
sewage, and bodily effluvia.

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Chapter 4:
“The Present was Everything” in Mary Barton
Approximately half-way through Mary Barton, Elizabeth Gaskell reflects: “Distrust each
other as they may, the employers and the employed must rise or fall together. There may be
some difference as to chronology, none as to fact” (166). In two simple sentences, she outlines
the systems of social, spatial, and temporal relations that govern her novel and the state of Great
Britain’s socio-economic body as she sees it. Regardless of class, all citizens share the same fate.
Connected by unbreakable ties, the people prosper or suffer together. Their progress is marked
by a spatial metaphor: to prosper is to rise, while to suffer is to fall across the topography of
human experience. This topography is accompanied by an uncertain chronology. The facts are
true, but the chronological relations between those facts may differ. Who shall rise or fall first,
and which event shall cause the other?
The rise and fall of the people, the “strange alternations between work and want” dictated
by economic trends, fluctuate cyclically like the respiration of a nation that Gaskell envisions as
a physical body (3). This body, although of a social rather than physical nature, follows natural
laws. When the social body is healthy, when it breathes regularly and gently, good times quickly
succeed bad times and people of all classes prosper. When its breath becomes labored, when bad
times last too long, the health of the whole nation suffers.
71
The social body, like the physical
body, is governed by the rules of sympathy that dictate the reciprocity of part and whole and
links social, economic, and biological prosperity. Gaskell, like her predecessors from the
preceding chapters, attempts to tell the story of this body despite its refusal to follow the

71
Gaskell frequently mentions “good times” and “bad times,” alluding to a certain inevitability
in their succession and suggesting that sympathetic generosity, such as Margaret’s offer of
money during the “bad times” that can be repaid during the “good times,” should be sufficient to
secure the health of poorer classes (140).

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chronological rules that narrative requires. Her story expresses the desire to trace a chain of
cause and effect that she must finally give up as impossible.
Unlike the novels of the previous chapters, however, Mary Barton focuses on the trials of
the laboring poor, whose suffering was dictated by the miasma that was now becoming a well-
established bedfellow of poverty in industrial towns. Through the iconic scenes of filth and
crowding that the social problem novel shared with medical pamphlets and governmental
reports, the logic of miasma reimagined and reinforced the relationship between body parts,
bodies, and social bodies posited by biological sympathy. Such scenes are typified by the
following description by a member of the Edinburgh Board of Health in 1832:
It will be found, that almost all malignant distempers, upon minute enquiry, arise from
quarters that are exposed to the noxious exhalations … Their [the city’s poorest] more
retired apartments were literally converted into dunghills; bones, ashes, old rags, and
frequently, remains still more abhorrent to the senses, were permitted to accumulate, and
rot till they had become one mass of putrefaction. (An Enquiry 11-12)
In such scenes, the discarded and diseased excrement of the individual body, through its effluvia,
had the capacity to spread disease to the whole community even as the economic poverty of the
community is what caused such scenes of disease. Like sympathy, miasma reinforced the
reciprocal relations between individual and social health without establishing a linear chain of
causation. In terms of the relationship between the part and the whole, the difference between
sympathy and miasma can generally be reduced to the fact that one transfers through the medium
of the nervous system, while the other transfers through the media of the respiratory and
digestive system.

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The digestive system, however, is much less genteel than the nervous system. One of the
dangers of creating graphic descriptions of human filth and misery is that it tends to dehumanize
those most closely associated with it. The supposed dullness of the nervous systems of the lower
class made them less sensible, cultured, and perceptive, and implied that they were more suited
to the living conditions they were forced to endure.
72
The above passage continues, suggesting
that the abodes of the poor were so horrible “as to render it literal suffocation to a person to
enter, who had not been accustomed to such scenes… yet so unconscious were the miserable
inmates, of their dangerous situation, as never once to have made an effort to rid themselves of
the nastiness which fastened upon every part of their hovels” (11-12). The ability to withstand
such odiferous filth suggests an animal-like unconsciousness or worse. Ironically, as Peter
Melville Logan has noted, the same insensibility that had preserved the lower class against
disease at the beginning of the century was now the cause of it (159).
Gaskell’s depiction of Manchester’s working poor blends the imagery of miasma and
sympathy into a topography of industrial disease. The dehumanizing forces of miasmatic effluvia
are tempered by her assertions of the sensibility of her poor characters who frequently act with
compassion and humanity despite their deplorable surroundings. She uses these two medical
concepts in coordination to emphasize the relationship between individual and community and to
suggest that the health of the social system depends upon the health of its smallest part. Her
novel provides a moral guide, one that draws upon medical wisdom to instruct reader and
character alike about how to navigate a social and spatial world in the absence of temporal
certainty.

72
See chapter six of Peter Melville Logan’s Nerves and Narratives for a nuanced explanation of
how the sensibilities and diseases of the lower class grew out of and in distinction to the
sensibilities and diseases of the middle and upper classes.

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Embodied Sympathies
In one of Gaskell’s most discussed passages, she writes:
The actions of the uneducated seem to me typified in those of Frankenstein, that monster
of many human qualities, ungifted with a soul, a knowledge of the difference between
good and evil.
The people rise up to life; they irritate us, they terrify us, and we become their
enemies. Then, in the sorrowful moment of our triumphant power, their eyes gaze on us
with mute reproach. Why have we made them what they are; a powerful monster, yet
without the inner means for peace and happiness? (165)
In these lines, one cannot refer to a body, or the body, or bodies, or even embodiment and fully
capture the way the concept of corporeality is operating. What Gaskell appears to be saying is
that the many bodies of the uneducated can be symbolized as the single body of Frankenstein’s
monster. “They” are “a” powerful monster. This group-cum-creature is embodied; it (they?)
possesses eyes, although it is unclear whether the passage refers to the two eyes of the monster or
the many eyes of the multitude. Yet, it is also disembodied in the sense that the monster refers to
the abstract concept of the political body, or “The People” writ large.
Moreover, Gaskell refers to the monster itself as Frankenstein, by then a conventional if
unconscious choice of metonym, that expressed that the monster is really an external figure for
what is monstrous about his creator.
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The metonym of “Frankenstein” for “Frankenstein’s
monster” conflates symptom (the monstrosity Victor unleashes on the world) with cause (Victor)
and illustrates how the symptoms of monstrous causes, an individual scientist or avaricious
economic masters, can cause further monstrosity in themselves. This epidemiological loop or

73
See Susan Tyler Hitchcock’s Frankenstein: A Cultural History for a comprehensive history of
the creation, reception, and afterlives of Shelley’s Frankenstein.

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uncertainty of what is symptom and what is cause is precisely what unites Gaskell’s and
Shelley’s interests. Gaskell depicts this uncertainty and its moral-political implications for
understanding capitalist relations. She replaces the elusive “chronology” of her “facts” with a
consideration of the relations between parts and wholes that move together through sympathetic
influence.
The Frankenstein passage disrupts our ability to demarcate the boundaries between
bodies and differentiate between parts and wholes. It suggests that an individual worker should
be thought of as both a whole person and as simply a limb of a larger body.
74
The body parts first
dug up by Victor Frankenstein and stitched together to create his monster serve in this passage to
symbolize the individual bodies that have been stitched together to create a monstrous political
body. Likewise, the struggles of John Barton work within the larger novel to depict the trials,
strengths, and weaknesses of the working class more generally. As Lucy Sheehan has noted:
“Gaskell begins by describing the working classes as ‘typified’ by Frankenstein, in the same way
that they are ‘typified’ by John Barton: a single figure is representative of the whole but it is also
only a part of that whole” (42). By “typifying” the working classes in the single body of a
monster, or the tragic John Barton, Gaskell illustrates Dr. Abernethy’s premise given to his

74
Rosemarie Bodenheimer notes that the bodies of the union members who come to Mary’s
house to speak with her father take on a dismembered form as well. She cites the passage in
which “Strange faces of pale men, with dark glaring eyes, peered into the inner darkness, and
seemed desirous to ascertain if her father were at home. Or a hand and arm (the body hidden)
was put within the door, and beckoned him away” (Mary Barton 115). Her argument is that
“those truncated pieces of bodies are dangerous because they intrude insidiously into the safe
space of home, threatening to beckon the father away both physically and psychologically. The
dehumanization of the union suggested by those images is extended in the depiction of its effect
on Barton: he becomes more isolated as he becomes more involved, as though a union could not
provide the companionship that it might naturally foster” (205). The depiction of the union’s
fragmented bodies serves the same purpose as the metaphor of Frankenstein’s monster. It
suggests an image of an improperly formed body or bodies that lacks the healthy sympathy of
communication between parts. The communication that is missing is, of course, that between the
working poor and the middle class.

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students in 1824 that “local disease, injury, or irritation, may affect the whole system, and induce
general disorder, -- characterized, however by more especial disturbance of some parts of the
system” (“Mr. Abernethy” 5). John Barton is an “especially disturbed” part of his community.
He feels an acute sense of injury that does indeed produce a more general disorder; he leads
strikes and promotes Chartism before eventually committing murder. But at the same time, his
injury is produced precisely by those general conditions that plague the working class in the first
place – their inability to be paid a wage that will provide for their families. The reciprocity
between the part and the whole that the novel illustrates depends on the Romantic idea that, for
both bodies and communities, a part corresponds with the larger whole through sympathetic
communication – an idea that lived on in medical discourse about epidemic disease.
75
What
holds true for a single biological body also appears to hold true for the larger social body.
Gaskell, like Mary Shelley, was preoccupied with the role that sympathy plays in
structuring natural and social orders. Gaskell invokes the term over forty times in Mary Barton,
which, she claimed, stemmed from her “deep sympathy with the care-worn men” of the working
classes and which concludes with the rather heavy-handed wish that “a perfect understanding,
and complete confidence and love, might exist between masters and men; that the truth might be
recognized that the interests of one were the interests of all” or, that British communities might
be united in a feeling of sympathy (374). For Gaskell, the problem was that the working classes
received no sympathy from their “masters,” much like Frankenstein’s monster himself, and
therefore resorted to monstrous measures.
Crucially, for Gaskell, the image of Frankenstein is a diseased, barely functioning body.
The lifeless limbs and dead organs, possibly stolen from those who had succumbed to disease

75
See the introduction to Chapter 3 for a more detailed description of how sympathy remains an
important concept in pathology well into the Victorian period.

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themselves, symbolize the metaphorical disease of the working classes who lived in poverty and
misery, yes, but it also symbolizes their literal diseases, which she portrays in detail throughout
the novel. The organism that is the working-class functions but only imperfectly. Sympathy
binds the working class together in an organic whole, predisposed to kindness and affection but
made miserable, sick, and hungry precisely due to the lack of a different, healthier, and more
voluntary sympathy which should bind the entire community together regardless of class.
76
In the
absence of this healthier sympathy, the disease of the working class emanates outwards. Like
Frankenstein’s monster, the working class not only suffers but also, especially in the case of John
Barton, lashes out at the larger community.
Although Gaskell occasionally distinguishes wealthy life from the life of the poor, such
as when John Barton leaves the side of a sick fellow worker and “he felt the contrast between the
well-filled, well-lighted shops and the dim gloomy cellar, and it made him moody that such
contrasts should exist,” the novel shows that what befalls the working class will also reverberate
throughout the leisure class despite these apparent discrepancies (60). When Mr. Carson
confronts John Barton at the end of the novel, their commonalities become apparent. Through a
moment of free indirect discourse, Gaskell reflects:
Rich and poor, masters and men, were then brothers in the deep suffering of the heart; for
was not this the very anguish he had felt for little Tom...!
The mourner before him was no longer the employer; a being of another race,
eternally placed in antagonistic attitude going through the world glittering like gold, with

76
Bodenheimer notes that John Barton remarks in the first chapter: “It’s the poor, and the poor
only, as does such things for the poor” (Mary Barton 11) and remarks that “Gaskell’s series of
domestic tableaux show just how well, how graciously, how sensitively, how courageously and
good-humouredly, the poor do such things" (197-8). However, the poor, isolated from the
compassionate sympathy of the rest of society, cannot ameliorate their problems by themselves.

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a stony heart within, which knew no sorrow but through the accidents of Trade; no longer
the enemy, the oppressor, but a very poor and desolate old man. (353)
John Barton’s tortured actions have caused Mr. Carson to suffer in the same ways that he does.
Having lost a son due to scarlet fever and starvation, his “body took its revenge for its uneasy
feelings. The mind became soured and morose, and lost much of equipoise.” He murders Harry
Carson in his embittered “monomania,” leaving Mr. Carson bereft of his son as well (164). As
Rosemarie Bodenheimer notes, “Through killing Harry, Barton creates in the elder Carson a
master who is capable of becoming a ‘brother’ in suffering… their similarities of character –
revenging and then relenting—effect the temperamental brotherhood that would seem to
overleap the social gap” (206-7). In the end, Mr. Carson has become just as impoverished as the
workers he and others like him employ; both John Barton and Mr. Carson are “poor and
desolate” old men with their fates sympathetically intertwined.
By diagnosing Barton with “monomania,” or rather, assuring us that he would be so
diagnosed if there were “physicians to give names to them” in such low haunts, Gaskell suggests
that she viewed her character’s behavior as pathological. Monomania was a form of insanity that
was gaining increasing publicity during the 1840s and was associated with a lower-class hatred
of the upper class (Stewart 493). Monomania was considered to be a form of nervous order that
led to insanity and which could be caused by a “shock to the nervous system” (Hall 293). As
such, it, like the more general nervous irritabilities discussed in previous chapters, was at once a
disease of the soul and a disease of the body. Gaskell takes pains to emphasize the embodied side
of monomania, alluding to Barton’s “bodily privation” that causes John’s monomania and
eventual desire to commit murder. The underlying message is that if healthy sympathies cannot
bind the social classes together, then the “body will take its revenge” and bind the social classes

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together through an unhealthy sympathy instead, spreading the diseased body of the individual
across the community.
It is this diseased form of sympathy that shapes the anxieties expressed by her
Frankenstein metaphor and, I argue, the formal conventions of the condition of England novel.
The genre relies on the uneasy correlation that is an inherent part of theories of biological
sympathy: that the narrative of the pathologies of a single person corresponds with the narrative
of the troubles that infect the entire community, extending even to national identity. In the case
of Mary Barton, the eventual personal reconciliation of John Barton and Mr. Carson not only
symbolizes but also helps to make possible a better reconciliation between the workers and
masters of Manchester on a larger scale through the reformation of Mr. Carson.
77
The narrator
writes: “Many of the improvements now in practice in the system of employment in Manchester,
owe their origin to short earnest sentences spoken by Mr. Carson. Many and many yet to be
carried into execution, take their birth from that stern, thoughtful mind, which submitted to be
taught by suffering.” Mr. Carson’s suffering, which makes him sympathetic with the suffering of
John Barton and the workers in general, leads him to desire a healthy sympathy throughout the
entire production system, which should be united by “a perfect understanding, and complete
confidence and love…between masters and men” (374).
78

77
Shirley Foster notes that “Mary has to realize that she really loves Jem; Carson has to realize
that he is part of a wider world of suffering. At this individual level, this enacts the novel’s wider
message that until men and women, masters and workers, understand and sympathize with each
other there will never be resolution of conflict, personal or societal” (xix).

78
Conversely, Jem and Mary do not find sympathy in Manchester after Jem is accused of
murder. In this instance, his personal tragedy infects the entire community. Following a marriage
plot similar to that in Sense and Sensibility, the newly married couple must leave their original
seat and find sympathy within a different community in Canada.

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In the case of another prominent condition of England novel, Benjamin Disraeli’s Sybil
(1845), the eventual marriage of Egremont and Sybil both symbolizes and literalizes the
reconciliation of Disraeli’s “Two Nations, governed by different laws, influenced by different
manners, with no thoughts or sympathies in common” (299).
79
The force of such novels relies on
an assumption that there is a sympathetic correlation between individual experience and larger
social problems and that acknowledging such a correlation is a crucial step in transforming a
diseased society into a healthy one – a project that the condition of England novel
enthusiastically participates in. The “penury and disease” that feed “upon the vitals of a
miserable population” in Sybil functions much like Gaskell’s Frankenstein metaphor (80). The
image of a single body serves as a synecdoche for a social body that is out of a sympathy with
itself and therefore diseased.
Catherine Gallagher has explored the tensions that permeate the condition of England
novel in a slightly different context. Thinking in terms of public and private spheres, rather than
in the related terms of the individual and the community, she notes:
“Industrial novels… display this normal tension [between public and private realms] in
exaggerated form…Bringing the public and private realms of life into greater proximity
is thus crucial to the novels’ reforming programs. However, if the family is to function as
either a model or a school of social reform, it must, paradoxically, be separated from and
purged of the ills infecting the public realm.” (114-5)

79
Although not alluding to sympathy specifically, Meegan Kennedy has noted how the narrator
of Sybil “uses it’s public health failures as a synecdoche for the economic and political health of
the land, and the consequences for England’s moral and spiritual health” (12). She likens the
diseases that Disraeli mentions, such as consumption, synochus, and ague to “cancers of the
body politic” (12). However, cancer seems an infelicitous metaphor in these circumstances,
given the very real and literal, as well as symbolic, connections of predominantly epidemic
diseases with economic and and cultural well-being. This will be discussed more in the next
section.

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For Gallagher, the domestic family and productive community are interrelated in industrial
fiction. The demarcation between what is public and what is private relies on many factors and
should not be conflated with boundaries between individuals and the community. However, since
Gallagher and others, including many Victorians, frequently viewed the private realm in terms of
the domestic family, the public and private often took on a relationship between the part and the
whole, with the domestic family often being seen as the ideal unit from which to constitute the
larger community. In order to achieve a better community, industrial writers suggest that
communities should more closely resemble the smaller groupings of families which constitute
them. However, Gallagher points out that such a project is paradoxical because in order to be a
model, the domestic family must be separated from the problems of the larger society.
While I agree with Gallagher’s analysis, I argue that it is incomplete without
understanding the role of sympathy in the elaborate analogy between individuals and the
community and their relation to disease. Sympathy provides the mechanism by which the
domestic family both affects and reflects larger society. This is perhaps best illustrated by a brief
vignette near the end of Mary Barton involving the domestic troubles of two children and a
nurse. A little girl, clearly from a family of some wealth and accompanied by her nurse, is
carelessly knocked down by an older boy of the laboring class. While blood drips down the girl’s
face, the nurse drags the terrified boy towards the nearest policeman until she is stopped by the
little girl who protests that “he did not know what he was doing” and allows the boy to kiss her
cheek “as she had been taught to do at home” (355 emphasis mine). A passerby then observes:
“That lad will mind, and be more gentle for the time to come, I’ll be bound, thanks to that little
lady” (355). In this case, the domestic habits that the little girl learned at home allow her to avert
a crisis in the public streets that would end in more misery for the working-class boy, and

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further, to teach the boy an important lesson which will influence his future behavior. The
episode rather obviously parallels in miniature what the entire novel illustrates: that the upper
class must have sympathy for the lower class and treat them with kindness, which will influence
the lower class to act with less violence and unrest. By observing this small individual act, Mr.
Carson comes to realize his own moral obligation to John Barton and subsequently to affect
change for the working class in Manchester. It is the domestic traditions learned by the little girl
in the smaller setting of the home that should be applied to the larger context of society.
Moreover, the lessons from this small vignette are transferred to the larger social system
through the body of Mr. Carson and its sympathetic mechanisms. Mr. Carson observes this event
at a moment in which he is trying “to recal [sic] his balance of mind by walking calmly and
slowly, and noticing everything which struck his senses” (355). In other words, he is deliberately
increasing his sensibility to sensory stimuli when the accident occurs. Despite the fact that Mr.
Carson “took no apparent heed of the remark, but passed on,” the incident makes an involuntary
impression upon him through his senses, leading him to forgive John Barton and to attempt to do
good in his community. While he eventually must make an active choice to act on the
impression, the initial influence of the little girl is not cognitive, but rather strikes him directly
through the nervous system.
Conversely, for those whose minds have, through privation, lost the ability to make the
active choice of sympathy, biological sympathy can negatively affect the domestic household by
reflecting larger societal troubles. When, as a Chartist delegate and leader of the Trades Union,
John Barton fails to find work in the factories, the politics of public life permeate and alter John
and Mary Barton’s home:

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The house wanted the cheerful look it had had in the days when money was never wanted
to purchase soap and brushes, black-lead and pipe-clay. It was dingy and comfortless; for,
of course, there was not even the dumb familiar home-friend, a fire… If her father was at
home it was not better; indeed, it was worse. He seldom spoke, less than ever; and often
when he did speak, they were sharp angry words, such as he had never given her
formerly. Her temper was high, too, and her answers not overmild; and once in his
passion he had even beaten her. (114)
In this case, the logic of sympathy causes the problems of Manchester to permeate the Bartons’
home and destroys their ability to act with compassion towards each other. The external
conditions of lack of work and civil unrest contribute to Barton’s nervous irritability and ill
health, which consequently affects his domestic space. The microcosmic system of the domestic
household and the macrocosmic system of the larger community reflect and affect each other
through an involuntary, biological form of sympathy. Yet, paradoxically, to create health on both
the microcosmic and macrocosmic levels, there must be a positive change experienced in one
part (usually the domestic part, in the case of industrial fiction), which implies a separation
between the micro- and macrocosmic systems.
80
This positive change is caused by the presence
of sympathy that does not simply reflect the condition of its surroundings but rather creates a
willful compassion that elevates the functioning of both large and small systems. Or, in
Gallagher’s words, the domestic household must be understood in “proximity” to public life at
the same time that it must “be separated from and purged of the ills infecting the public realm.”

80
This positive change works as the “healthy crisis” discussed in both biological and social
contexts in Chapter 3.

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The Topography of Miasma
Many of the “ills” afflicting the new industrial public realm were configured as disease
and spread through miasma.
81
Consider the following description from Chadwick’s Report on
the Sanitary Condition of the Labouring Population (1842) of a poor section of Glasgow in
which “the great mass of the fever cases occurred… because lodging was there the cheapest, the
poorest and most destitute naturally had their abodes”:
We entered a dirty low passage like a house door, which led from the street through the
first house to a square court immediately behind, which court … was occupied entirely as
a dung receptacle of the most disgusting kind…There were no privies or drains there, and
the dungheaps received all the filth which the swarm of wretched inhabitants could give;
and we learned that a considerable part of the rent of the houses was paid by the produce
of the dungheaps. Thus, … the dwellers in these courts had converted their shame into a
kind of money by which their lodging was to be paid …We saw half-dressed wretches
crowding together to be warm; and in one bed, although in the middle of the day, several
women were imprisoned under a blanket, because as many others who had on their backs
all the articles of dress that belonged to the party were then out of doors in the streets…
Who can wonder that pestilential disease should originate and spread in such situations?
(24)

81
Erin O’Connor has noted the particular links between economic and bodily suffering inherent
in the dual meaning of “consumption”: “capitalism describes a cultural pathology in which a
constitutional inability to assimilate wealth produces an increasingly enfeebled and diminished
social body; unable to make use of its own material resources, able to produce but not to
consume, commercialized England is literally wasting away” (1). This cultural pathology was a
common trope in critiques of the social and economic state of Great Britain across various
genres.

115
The passage describes a circular economy of poverty, dung, and disease. Poverty has restricted
the tenants’ ability to labor, taking even the clothing necessary to enter the public realm, but their
most basic biological functions still serve as a mode of production. To live, to excrete, is to
produce. Not only do the tenants produce feces, but through that feces, they also produce disease
as “the most foul and putrid mass” spreads “the fumes of contagion” and produce “different
types of fever and disorder of the stomach and bowels” (Report 17). While the generation of
feces secures their lodging, it does not give them the means to consume. Lack of food, clothing,
and other necessities exacerbates the effects of disease, which in turn further decreases their
ability to labor, thereby ensuring that they do, indeed, “waste away;” their ability to manufacture
feces is the last act of participation in a spiraling economy that eventually turns them into same
inanimate, effluvia-producing animal matter that they hitherto produced.
82

Miasma theory attributed the diseases of the poor directly to the inhumane living
conditions necessitated by poor wages despite the fact that little was actually known about the
exact mechanisms causing such diseases. As Gaskell puts it: “This disparity between the amount
of the earnings of the working classes and the price of their food, occasioned, in more cases than
could well be imagined, disease and death” (82). Although the poverty found in Mary Barton is
not quite as dire as that described above, the system of privation and disease remains the same.
In a scene that bears a remarkable similarity to Chadwick’s Report, Gaskell describes the living
conditions of a poor family in the throes of fever
83
:

82
Most miasmatists did not ascribe disease solely to feces but also to the “putrefaction” of any
kind of vegetable or animal matter, including dead bodies. For more on this circular
bioeconomics, see Catherine Gallagher’s chapter on “The Bioeconomics of Our Mutual Friend”
in The Body Economic.

83
Peter Melville Logan claims that Gaskell “inserts” part of Chadwick’s Report in her
description of the Davenport’s dwelling (145). However, I have found no evidence of any direct
quotations. Rather, both descriptions belong to a trope of poverty and disease that is a hallmark

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[Berry Street] was unpaved and down the middle of a gutter forced its way, every now
and then forming pools in the holes with which the street abounded…Heaps of ashes
were the stepping-stones, on which the passer-by, who cared in the least for cleanliness,
took care not to put his foot… You went down one step even from the foul area into the
cellar in which a family of human beings lived … the smell was so fœtid as almost to
knock the two men down. … three or four little children roll[ed] on the damp, nay wet
brick floor, through which the stagnant, filthy moisture of the street oozed up; the
fireplace was empty and black; the wife sat on her husband’s lair, and cried in the dark
loneliness…He lay on straw, so damp and mouldy, no dog would have chosen it in
preference to flags: over it was a piece of sacking, coming next to his worn skeleton of a
body; above him was mustered every article of clothing that could be spared by mother or
children this bitter weather; and in addition to his own, these might have given as much
warmth as one blanket.” (58-61)
This scene operates on a logic of embodied and diseased sympathy that evokes a deeply visceral
sympathetic revulsion despite its lack of bodily description. Or rather, it evokes this revulsion
because the description of the environment is a bodily description. Those familiar with the worst
streets of Manchester or those who had read Chadwick’s Report would know that the gutter that
forms the street is filled with stagnated water and “so covered with refuse and excrementitious
matter as to be almost impassable from depth of mud, and intolerable from stench” (38). The
“exrementitious matter” was once literally parts of the bodies, both animal and human, that
inhabit the neighborhood; the smell that almost knocks Wilson and Barton over as they enter the
cellar is the effluvia rising from the bodies of Davenport’s family. Even the moisture that the

of the social problem novel but that crosses medical, legal, and fictional genres and pre-dates
both authors.

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children roll in oozes up from the streets, implying that it is a product of the same excrement that
lines them. The innards of the body have been turned outwards, creating what Erin O’Connor has
described as a “fecal topography” (39). Much like Gaskell’s Frankenstein metaphor, the scene
disrupts the membranes separating individual bodies from their communities with similarly
monstrous and diseased consequences because “the seeds of many diseases… seem to be
generated by excrementitious matter of every description thrown off from the body” (Hodgkin
18). Through filth, depictions of miasma reimagine the relationship between body parts, bodies,
and social bodies posited by biological sympathy.
Passages like the ones above, which connect larger economic and social systems to the
individual body through the visceral realities of disease, were a hallmark of the condition of
England novel both before and after Chadwick’s Report. In Benjamin Disraeli’s condition of
England novel, Sybil, he describes the town of Marney where, “continuous to every door might
be observed the dung-heap on which every kind of filth was accumulated, for the purpose of
being disposed of for manure, so that, when the poor man opened his narrow habitation in the
hope of refreshing it with the breeze of summer, he was met with a mixture of gases from
reeking dunghills” (81). Poverty, dung, and disease are always present, connected through the
compulsion engendered by extreme privation to use “waste” as “produce.”
Although the intense poverty of certain members of the lower classes was often attributed
to immoral habits, the living conditions of the Davenport family, Gaskell tells us, are simply a
result of an unjust system and are a direct result of virtuous poverty.
84
Wilson informs John

84
Dr. Thomas Hodgkin writes in 1841: “Far be it from me to express, or even to entertain an idea
approaching to a want of feeling for the miseries and privations inseparable from poverty; but I
do not hesitate to declare, from repeated and careful observation, that the habits of too many of
the poor promote and foster various errors of negligence and ommission, which not only render
poverty more distressing and degrading, but which also tend to perpetuate it, and at the same
time render it more exposed to the attacks and ravages of disease” (25). He further adds: “The

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Barton that “Davenport was a good fellow, though too much of the Methodee; that his children
were too young to work, but not too young to be cold and hungry; that they had sunk lower and
lower, and pawned thing after thing, and that they now lived in a cellar” (58). Such poverty leads
to “‘The fever’ [which] was (as it usually is in Manchester) of a low, putrid, typhoid kind;
brought on by miserable living, filthy neighbourhood, and great depression of mind and body”
(59).
Despite using dehumanizing descriptions of filth to portray the direst effects of poverty,
Gaskell pushes back against the idea that the working classes are less sensitive or less human.
The conditions of the poor are the product of a defective social and economic system, she
suggests, not their own indifference. She depicts the same nervous irritability and refined
sensibility in her characters that prevailed in the more genteel society of Deerbrook or Sense and
Sensibility, implying that it is external circumstance that divides the poor from their richer
neighbors rather than internal biology. Mary Barton, in particular, suffers from all the
consequences of heightened nerves but implicitly also benefits from a heightened refinement.
After heroically travelling to Liverpool to track down Jem’s alibi for murder and after witnessing
the ensuing trial, Mary succumbs to the “nervous fear” that had plagued her for many days and
falls into a feverish delirium (285). By succumbing to the vicissitudes of her emotional struggles,
Mary Barton follows in the tradition of Marianne Dashwood, revealing a susceptibility to disease
but also a delicate nature usually associated with the middle and leisure classes. Likewise, for
Jem and his mother, the “intense excitement” of the trial “had produced its usual effect in
increased irritability of the nervous system” (327). By describing the working class as being

spirt-drinker is peculiarly susceptible of disease of all kinds; and consequently is likely to fall the
first victim to fevers, or other epidemic distempers” (140-1). Writers across genres often
attempted to distinguish between the sinful and the virtuous poor and such distinctions informed
many rules and regulations including Chadwick’s 1834 New Poor Law.

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susceptible to the same excesses of nervous sympathy as her middle-class readership, Gaskell
uses an older model of sensibility alongside the increasingly popular model of miasma theory to
assure the humanity and value of her poorer characters despite their immersion in a “fecal
topography.”
The literal piles of shit that were increasingly becoming the focus of miasma theory
merely overlaid a topography of disease that remained generally similar to previous decades.
Sympathetic relationships between parts and wholes continued to guide attempts across medicine
and literature to envision literal and social spaces while doctors and authors became more and
more precise in mapping and describing such spaces in order to gain the semblance of objective
authority. Shirley Foster has noted “The topographical specificity, both of Manchester and, in the
later chapters, of Liverpool, which Gaskell knew through cousins who lived there, gives the
novel a kind of gazeteer status. Like the author who almost daily ‘plodged’ through the
Manchester streets, the characters are constantly moving from place to place, linking the
different sections of the city” (xii). The novel opens with a verbal map: “There are some fields
near Manchester, well known to the inhabitants as ‘Green Heys Fields,’ through which runs a
public footpath to a little village about two miles distant” (5). The spatial details of the city and
its surroundings lend a sense of the real to Gaskell’s story and lend credibility to the narrator,
while the movement of characters reminds the reader that all the spaces of the city are connected,
leading to a “sense of authenticity” dependent on the sympathy and material specificity deriving
from personal observation” (x).
An Untraceable Cause of Woe
The authority that Gaskell gains from her spatial specificity is tempered by her
uncertainty about other epistemological approaches to truth and particularly to those that

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attribute causality. After a long meditation on what John Barton perceives to be the culpability of
the masters in the discrepancies between the lives of the rich and the lives of the poor, Gaskell
writes: “I know that this is not really the case; and I know what is the truth in such matters…But
there are earnest men among these people, men who have endured wrongs without complaining,
but without ever forgetting or forgiving those whom (they believe) have caused all this woe”
(23-4). While Gaskell begins the passage by affirming the existence of “truth” about the
causation of poverty and equally affirming her understanding of it, she immediately troubles her
declaration by pointing to the experience of men who actually have been wronged that have a
differing opinion. She omits who has wronged them, but placing “they believe” in parentheses in
the subsequent sentence lessens the subjective qualifier, implying that the working men may also
be speaking a version of the truth. Paradoxically, the factory owners are both at the mercy of a
larger economic system that causes poverty and also the cause of it themselves; both narratives
have truth value. Foster notes of this passage: “The narrative authority thus both upholds and
undermines the idea of knowledge as verifiable, and, in so doing, challenges an audience who
may equally fail to interpret accurately what they see” (xxv). While Foster acknowledges that
many of the narrator’s pronouncements “deal with the difficulty of expressing the ‘truth,’” she
does not reflect on the fact that these moments almost always pertain to dubious causalities and
uncertain chronologies (xxiv).
During the episode of the factory fire, the narrator inserts herself into the story several
times to explicitly remind the reader of the subjectivity of time. She explains that Mr. Wilson had
“perceived no sight or sound of alarm, till long after (if anything could be called long in that
throng of terrors which passed by in less than half an hour)” (50). Once again creating doubt
using parentheses, the narrator calls into question the length of time between the onset of the fire

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and the moment when Mr. Wilson notices it; we know it is less than half an hour, but whether it
is a long or short period of time is dependent on what the observer decides to call it. Similarly,
she writes a few pages later that after Jem Wilson rescues his father, he returns to rescue a
second man “in far less time than even that in which I have endeavoured briefly to describe the
pause of events” (53). Here, Gaskell juxtaposes the time it takes Jem to return for the second
rescue with the time it has taken her to write about it, and implicitly, the time it takes the reader
to read about it, destabilizing the novel’s mimesis by drawing attention to the fact that the
subject, the writer, and the reader cannot experience the same temporal “truth” about the duration
of events. The reader cannot know how long it has taken Gaskell to write about the pause of
events, cannot know how that time relates to how long it has taken the reader to read the
description, and therefore cannot know how long the pause of events really is. The reference to
time becomes meaningless.
In a slightly different context, Helena Michie has also analyzed what she calls the
“conflicting temporalities'' of Mary Barton (608). Citing the difference in chronological speed
between the thirty long, slow days of Aunt Esther’s prison term with the rapid, yet supposedly
simultaneous, events of Jem’s work plot and Mary’s marriage plot, she argues that “differences
in status and power produce different temporalities” (607). For Michie, Gaskell’s time is
malleable, differing not only between the categories of character, author, and reader, but also
differing between individual characters. Because each character experiences time differently, and
because, as the narrator tells us, it is “reckon[ed] by events and thoughts, and not by clock or
dial-plate,” confusion abounds about the causality of various events (323). Esther, in carceral
limbo during much of the work of Mary and Jem’s marriage plot, entreats Jem to save Mary
from the temptations of Harry Carson, not realizing that Mary has already been saved by a

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different cause: her love of Jem himself. Michie adds: “Esther’s understanding of Mary’s relation
to temporality is, of course, belated” (614). Jem, too, does not understand the causalities at work
because he has not experienced the accelerated “‘ten minutes’ of clock time that separate Mary
‘at…peace’ from Mary in ‘agonized grief’” that occur as she realizes that she does, indeed, love
Jem. These ten minutes “owe their transformative power to the temporalities of the marriage
plot” (Michie 610).
The conflicting temporalities of Gaskell’s characters make it difficult for them to trace
accurately the chains of cause and effect that dictate the events of the plot. This difficulty merely
echoes the struggles of Gaskell herself, who attempts a task that she admits is impossible: to
trace the causes of poverty and class conflict when “even philanthropists who had studied the
subject, were forced to own themselves perplexed in their endeavour to ascertain the real causes
of the misery; the whole matter was of so complicated a nature, that it became next to impossible
to understand it thoroughly” (82). Catherine Gallagher has written extensively about Gaskell’s
“ambivalence about causality,” which she attributes to a shift towards Transcendentalism within
Gaskell’s Unitarian faith (67). She argues that the novel is divided into two halves. The first
attempts to trace the inner and outer causes of John Barton’s downfall. However, Gaskell runs
into trouble because the determinism implicit in tracing these causalities contradicts Gaskell’s
investment in free will. In the second half, “the very causality that the narrator meticulously
traced through the first half is hidden…The events of the second half are more than an escape, an
avoidance, of the tragic problem; they represent the problem’s deliberate suppression”
(Gallagher 78). Gaskell’s inability to trace a line of cause and effect that is compatible with her
world view is echoed by struggles of John Barton, “the only character who consistently seeks
causes for the world’s phenomena, [but whose] analyses are marred by his ignorance, by the fact

123
that his understanding is circumscribed by his limited experience” (Gallagher 72-3). Both Barton
and Gaskell express a desire that remains unfulfillable: to trace temporally the sequence of
events that leads to poverty and misery.
Despite their nuanced analysis of Mary Barton’s chronological and causal
inconsistencies, neither Michie nor Gallagher connects those inconsistencies to the
epistemological realities of the diseased bodies within the text, an omission that is surprising
given the interconnection of poverty and disease both within the novel and within popular
discourse. Gaskell struggles to make sense of a system that produces the death and suffering of
the poor without being able to identify the underlying causes. In this sense, her interests are the
same as that of her medical contemporaries. While Gaskell’s focus is primarily of an economic
nature rather than medical one, both discourses overlap, sharing a chronotope that is confident
about the system’s geographical and spatial relations but unsure of where and how it exists
temporally.
Gaskell avoids tracing a chronology of events leading to poverty by changing genre and
suppressing the problem, but she also attempts the next best thing: connecting John Barton’s
poverty and hatred to their immediate, if not underlying, causes. Gallagher notes: “The links in
the tragic chain [John Barton’s life] are clearly identified and labeled: his parents’ poverty, his
son’s death, his wife’s death, the trade depression and the consequent suffering of neighbors, his
trip to London, his hunger, his opium addiction” (72-3). Beyond these immediate causes, as
Gallagher argues, he cannot see the larger economic forces from which his suffering originates.
Compare Gaskell’s attempt to identify the nature of poverty with the attempt of Dr. Peacock, her
contemporary, to identify the nature of disease in his treatise, On the Influenza or Epidemic
Catarrhal Fever of 1847-8 (1848):

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The precise nature of the cause or causes of the epidemic of Influenza, we must,
therefore, for the present, regard as involved in the obscurity that veils the origin of
epidemics generally. There can, however, be no doubt, that the more common
predisponents to disease, such as defective drainage, want of cleanliness, overcrowding,
impure air, deficient clothing, innutritious or too scanty food, &c., powerfully conduce to
the prevalence and fatality of the affection. (111)
Both Gaskell and Peacock admit their desire for, and yet the impossibility of, finding the true
origin of the problems they investigate. Instead, they enumerate the immediate circumstances
that appear to predispose their subjects to the given outcome, circumnavigating the difficulty of
finding an originary cause. Moreover, the “predisponents” of disease that Dr. Peacock lists are
amongst the exact same circumstances that predispose John Barton to sink further into poverty,
bitterness, and class warfare; it is the refusal of the masters to grant “a bit o’ fire for th’ old
granny, as shivers i’ th’ cold; for a bit o’ bedding, and some warm clothing to the poor wife who
lies in labour on th’ damp flags; and for victuals for the childer, whose little voices are getting
too fain and weak to cry aloud wi’ hunger” that eventually leads Barton to murder (182).
Novelists like Gaskell desire to know the social and economic causes of the condition of the
poor, while medical workers like Dr. Peacock desire to know the pathological causes. Yet neither
novelist nor doctor can fulfill their desire within the current framework of their discipline.
Therefore, the rhetoric of the two fields collapses into nearly identical lists of predisposing
circumstances envisioned within the same epistemology of time and space. The two passages
reveal just how deeply interwoven the discourses of poverty and disease were during the 1840s.

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Temporal Virtues
The chronological logic of Mary Barton is shaped not only by the difficulties of
attributing causality but also by the epistemic virtues that the novel promotes. In a move that
should be familiar to readers of the previous chapters, Gaskell presents concentrating on the
present moment while avoiding speculation about the future or preoccupation with the past as a
medico-moral imperative. This imperative is particularly espoused by Alice Wilson, a bastion of
morality and kindness for her family and friends. She reflects: “I sometimes think the Lord is
against planning. Whene’er I plan over-much, He is sure to send and mar all my plans, as if He
would ha’ me put the future into his hands” (75). Alice’s philosophy has much in common with
that of Deerbrook’s Mr. Hope and Margaret. Like them, Alice equates too much concern about
the future with a lack of faith in God.
85
But her sentiments, like theirs, display not only their
devotion but also their adherence to best medical practices. Alice, perhaps even more than her
predecessor Margaret, is a medical worker in her own right. Although practicing as an amateur
and using an older type of medicinal lore, Alice had “invaluable qualities as a sick nurse and…a
considerable knowledge of hedge and field simples” (16).
While her more rural approach to caring for the sick is very different from that of clinical
practitioners, she shares with them the view that disease can best be imagined in terms of the
present.
86
Alice’s gentle, rustic piety and knowledge of herbal lore evokes an older tradition of

85
Alice’s argument against planning here may initially seem ethically incompatible with a
statement like Dr. Moir’s, cited in chapter one, which argues for a “premeditated plan for
prosecuting enquiry” (9). However, Alice’s use of the word is substantially different from Dr.
Moir’s. Dr. Moir’s argument is primarily concerning consistent methodology; his plea for a
“premeditated plan” is a request that the rules of investigation be agreed upon and invariable.
Alice’s planning, however, is a speculation about the circumstances of the future, which both she
and Dr. Moir are firmly against.
86
In the words of Amy Mae King, “it would be a mistake to create a simple opposition between a
fading amateur tradition and a rising professionalized medicine” (259).

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rural medical practice, but at the same time, it also positions her, along with Job Legh, as one of
the natural historians of the working class that “may claim kindred with all the noble names that
science recognizes” (37). Like the “hung rude wooden frames of impaled insects,” the “cabalistic
books,” and the cases of “mysterious instruments” that mark Job’s dwelling as a place of science,
Alice’s cellar is strewn with the artifacts of medicine:
The cellar window… was oddly festooned with all manner of hedge-row, ditch, and field
plants, which we are accustomed to call valueless, but which have a powerful effect
either for good or for evil, and are consequently much used among the poor. The room
was strewed, hung, and darkened with these bunches, which emitted no very fragrant
odour in their process of drying…A small tin saucepan… served as a kettle, as well as for
cooking the delicate little messes of broth which Alice was sometimes able to
manufacture for a sick neighbour. (16)
Both Job and Alice represent a hopeful and knowledgeable element amongst the working poor of
Manchester, whose thirst for knowledge and interest in the natural world mirrors the rise of
medical, statistical, and scientific societies in more affluent sections of society.
87
Amy Mae King
argues: “Although Alice Wilson is nostalgic for the rural village she left as a child, her herbalist
work, like the naturalist studies of Job Legh, is resolutely work for the present; her knowledge of
herbal ‘simples’ is rural in origin but urban in practice” (257). In other words, Alice’s medical
knowledge cannot merely be seen as a relic of a time gone by but as an evolving product of
urbanization that is adapted to the working class.
Alice shares some of her medical philosophies with the newer, though not yet fully
clinical, philosophy of early nineteenth-century medicine, and Gaskell presents such

87
See A. Batty Shaw’s, “The Oldest Medical Societies in Great Britain” in Medical History and
W. F. Bynum’s Science and the Practice of Medicine in the Nineteenth Century p65-6.

127
philosophies both as a moral imperative and as best medical practice. Waiting attentively, ready
to observe change and give care without expectation for the future, is the particular purview of
the good medical worker, which Jem discovers to his dismay while Mary is recovering from her
post-trial delirium: “And now Jem found the difficulty which every one who has watched by a
sick bed knows full well; …the difficulty of being patient, and trying not to expect any visible
change for long, long hours of sad monotony” (335).
88
“Trying not to expect” is the chief task of
anyone monitoring the sick, who must not bias their observational acumen with hopeful
speculation. For Gaskell, Alice’s practices of observant caregiving contrast with masculine
medical traditions embodied by the druggist and the doctor that appear in the novel. The druggist
and the doctor fail to care successfully for their patients by refusing to observe at all. Towards
the beginning of the novel, the druggist prescribes a medicine without seeing his patient,
Davenport, which proves futile and leads to the man’s death. Later, a doctor who is called to
diagnose Mrs. Wilson does examine her but does not provide a diagnosis based on his
observations, deferring instead to Mary’s wishes in the case. Gaskell’s critique of such
professional medical practice hinges on the lack of compassionate watchfulness that is embodied
by Alice’s “offer to sit up” with sick children (12). It is also a critique shared by the newer
medical practices depicted in The Lancet, in which Dr. G. H. Barlow asks in 1843, “What is a
good medical man?” and answers “one who applies a logical mind to accurate observation of
disease” (209). Thus, Gaskell’s depiction of good and bad medical workers lauds epistemic and

88
In The Sickroom in Victorian Fiction, Miriam Bailin acknowledges that sick room scenes in
the early and mid-nineteenth century “resist the forward energies of the recuperating self” (6).
Yet she disavows the connection between this resistance and new epistemologies of medical
thought. I argue, however, that the particular resistance to forward movement in both biological
healing and narrative plot stem from a new emphasis on observation and repudiation of
speculation during this time period that preceded the more easily recognized features of clinical
medicine that occur mid-century.

128
moral virtues that coincide with both an older and feminized tradition of care and a newer, more
clinical practice that her Manchester doctors fail to practice, bridging old and new medical
traditions.
The patience learned from moments of medical caregiving can be applied with good
effect to other situations as well and Gaskell explores the potential of this medical philosophy
outside of the sick room. Like Austen, she transforms the epistemic virtue of the doctor into a
moral virtue for the marriage plot when Margaret gives Mary the advice to wait for Jem to
discover her love rather than telling him of it, noting that “waiting is far more difficult than
doing…many a one has known it in watching the sick; but it's one of God’s lessons we all must
learn, one way or another” (140). As the previous chapters have shown, waiting and observing
without speculation was central to a medical field that relied primarily on current observations to
give information about phenomena of the body that could not be traced through time to primary
causes. Gaskell struggles with a similar epistemological dilemma as she abandons her attempts to
illustrate the underlying causes of poverty and substitutes a domestic tale that endorses “simply
acting, doing one’s immediate duty, without stopping to ponder all of the consequences”
(Gallagher 82). Of course, sometimes the action that must be completed in order to do one’s
immediate duty is simply to wait, but whether waiting or acting, the message remains the same:
don’t confuse present knowledge by thinking about the future.
89

89
Bodenheimer has an instructive but slightly different take on the philosophy of “waiting” that
is adopted by Alice. She compares it with Mary’s waiting for Jem to declare his love for a
second time and “This Victorian modesty [of Mary waiting for Jem to again declare his love]
strains against the energy of Mary’s character, and the tension produces a small narrative
explosion when it comes time for Mary to act” (210-2). Bodenheimer makes the distinction
between passivity and action in these moments, as in others within the novel, while my own
argument examines more closely the motives behind such passivity or action. I contend that the
epistemic virtue governing the novel is the trait of choosing to act or wait based on the
circumstances of the present moment rather than choosing to act or wait based on wishes about
the future.

129
For Alice, the underlying chronological uncertainties present in her medical vocation also
manifest in her personal experience. Alice progressively gets sicker throughout the course of the
novel, suffering from a stroke and finally dying. From the time that she first suffers her stroke
her demise (a time that spans over a hundred pages of the novel although it encompasses only a
week of the narrative’s time), Alice lives in an uncertain chronology of her own. She believes
herself to be a child again and “though earthly sight was gone away, she beheld again the scenes
she had loved from long years ago! She saw them without a change to dim the old radiant hues”
(327). Symbolically, Alice embodies the condition of the medicine she practices. In her illness,
she cannot grasp the links of cause and effect that have brought her to the present moment. In a
disorienting situation similar to that of Lionel Verney in The Last Man, time ceases to have
meaning as she confronts her own dissolution. However, Gaskell transforms Alice’s weakness
into a strength, recasting her temporal confusion as a “veiled blessing” because “her work here
was finished, and faithfully done” (209, 327). For her, faithful waiting and watching at the
bedside of her neighbors and the dissemination of her herbal treatments were sufficient to live a
good, pious life and find happiness despite her inability to distinguish cause and effect; Alice’s
life reflects and personalizes the medical philosophy of her professional and non-fictional
medical compatriots, whose success in their vocation depends not on their ability to ascertain the
causes of disease, but, according to Dr. Sandwith in 1835, on their “talent for observation [and]
decision in the use of appropriate remedies” (Remarks 10).
As both the most admired medical practitioner and the most reliable moral arbiter of the
narrative, Alice bridges medical and ethical epistemologies. Through Alice, Gaskell tells us how
best to gain knowledge and how to best use it. Moreover, Gaskell reveals how these best
practices can be used in other spheres including the industrial world and domestic space, which,

130
like bodies, operate in sympathy with one another. For Mary, the medical lesson that Alice
embodies becomes a moral lodestar during what is arguably the climax of the novel: when Mary
must testify during Jem’s murder trial. The epistemic virtue that guides doctors in their
understanding of time becomes a moral virtue that guides the novel. Finally given a chance to
express her love for Jem, to bring a sympathy of understanding between her “heart’s secrets” and
the public world, she realizes one of Gaskell’s most important messages and an important theme
of both early nineteenth-century literature and medicine: “The present was everything; the future,
that vast shroud, it was maddening to think upon” (313).
Looking Forward
This chapter ends counterintuitively with precisely that maddening practice which
Gaskell warns against: looking forward. From our stance as modern readers, however, looking
forward also entails looking to the past, to the authors that immediately follow Gaskell and the
new narrative practices that they embrace. In fact, from our privileged point of view a century
later, Gaskell herself seems at moments to be looking forward to future literary trends despite her
avowal of epistemic virtues that value the present. This is because her novel, much more than the
novels of the preceding chapters, relies upon suspense – that peculiar kind of looking forward
that Caroline Levine associates with the skeptical scientific methods and realism of the mid-
century – even as it simultaneously warns against such practices.
90
When Mary, near the end of
the novel, rows after the ship bearing away Will Wilson in order to bring him back as Jem’s only
alibi against his murder charge, we as readers await breathlessly for the outcome. Will Mary
reach the ship in time? Gaskell suspends this question over a chapter break, inviting a pause in
which to imagine the future. Even after Mary reaches the ship, we must ask again: Will Will

90
Gaskell complains of Martineau’s writing that “The story is too like a history – one knows all
along how it must end” (qtd. in Gallagher, Industrial Reformation, 66).

131
reach the trial in time to testify on Jem’s behalf? This time we must wait four chapters to find
out. Such pauses do educate the reader in that patient practice of “trying not to expect” that Jem
finds so difficult during Mary’s illness. But they also reveal the impossibility of fully adhering to
such a practice and introduce us to the pleasures of speculation that seem to conflict with the
epistemic virtues of gentle, wise Alice.
To understand the seeming conflict that Gaskell poses through her style, we must turn to
the underbelly of the novel, to the world of policeman and prostitutes. Here is where the
pleasures of suspense are fully articulated. As Gaskell reflects on the reward that Mr. Carson
promises for the capture of his son’s murderer, she writes:
There is always a pleasure in unravelling mystery, in catching at the gossamer clue which
will guide to certainty. This feeling, I am sure, gives much impetus to the police. Their
senses are ever and always on the qui-vive, and they enjoy the collecting and collating
evidence, and the life of adventure they experience; a continual unwinding of Jack
Sheppard romances, always interesting to the vulgar and uneducated mind, to which the
outward signs and tokens of crime are ever exciting. (213)
The idea that the “pleasure of unravelling mystery” is for “vulgar and uneducated mind[s]”
echoes the earlier sentiments of Martineau, who as we have seen, decries the “plots and secrets”
of children and believes that the “love of mystery-making” goes away as “people grow wiser.”
The “gossamer clue” is simultaneously the object of suspense that allows the policeman to
speculate about past crimes and how they were committed, and to anticipate the future,
imagining the different ways that the clue could give meaning when the crime is solved. To an
extent, the policeman adopts the same epistemology as the doctor; he “collects and collates”
evidence with senses that are “ever and always on the qui-vive,” but the policeman uses this

132
epistemology for different and less admirable ends, rejecting the epistemic virtue of staying in
the present in favor of speculation and theory which, as the novel goes on to show through Jem’s
innocence, is often wrong.
Gaskell’s rhetorical policeman takes on flesh and blood a few pages later, when a
member of the Detective Service visits Mrs. Wilson in order to confirm that the murder weapon
belongs to her son. When Mrs. Wilson, ignorant of the accusations leveled against Jem, quickly
confirms that the gun is his, the policeman feels “contempt” and “disappointment” because “he
liked an attempt to baffle him; he was accustomed to it; it gave some exercise to his wits and his
shrewdness” (215). The policeman takes pleasure in a moment of suspense or a doubtful pause,
but this pleasure is neither serious nor scientific as Levine would have it, but rather degenerate.
91

Thus, it may be no surprise that the only other detective in the novel is a prostitute.
Esther, Mary’s fallen aunt, is drawn by “a craving desire to know more” to the murder scene of
Harry Carson, where she stands still, “imagining to herself the position of the parties, guided by
the only circumstance which afforded any evidence” (226-7). In the hedges she finds a clue: a bit
of paper used as wadding for the murderer’s gun. What’s more, she finds writing on the paper
that implicates Jem Wilson in the murder. Esther, like the policeman that will appear in the
subsequent investigation, gives in to the pleasures of speculation. Her “craving desire” to know
the cause and the manner of the murder appears a natural extension of her craving desire for

91
The “vulgar” pleasure in delay displayed by the policeman is akin to the narrative
phenomenon described by Peter Books as “a turning back from immediate pleasure, to ensure
that the ultimate pleasurable discharge will be more complete” (101-2). For Gaskell, as for
Brooks, the anticipation of the future that is inherent in moments of suspense is an erotic
pleasure, one that is seductive, deviant, and definitely immoral.

133
alcohol, which keep her living on the streets.
92
And, like the policeman, her imagination will
exceed the evidence before her, leading her to theorize that Jem has committed the murder.
93

What, then, should we make of the moments when Gaskell invites the reader to engage in
precisely those practices of speculation that are elsewhere relegated to policeman and
prostitutes? When we as readers pause at a chapter break, not yet knowing whether Mary will
reach Will before the ship sails or whether Will will reach the trial before Jem is condemned, we
are confronted with a choice in readerly practices. We may engage in that “waiting” which “is
far more difficult than doing” that is part of the epistemology espoused by Alice and associated
with caring for the sick. Or we may engage in the speculation and imaginings of Esther, whose
“poor, diseased mind” theorizes incorrectly about what has happened in the past and how it will
affect what happens in the future. Through these moments of suspense, Gaskell draws the reader
into the same moral and epistemic predicaments that confront her characters. Shall we choose
patience or shall we choose speculation? Gaskell makes it clear which path leads to moral and
epistemic virtue; within the world of Mary Barton, speculation is always both vulgar and
inaccurate. Yet the choice is ours. For most readers, these moments of temptation will be too
pleasurable to refuse, and the “craving desire” will be too sweet. In these moments, the reader.

92
She tells Jem: “I must have drink… If I go without food, and without shelter, I must have my
dram!” (159). Her need for alcohol mirrors John Barton’s need for opium, which Gaskell treats
in much the same way: “[John Barton] had hesitated between the purchase of meal or opium, and
had chosen the latter, for its use had become a necessity with him” (120). Esther’s alcoholism
and John Barton’s opium addiction have exacerbated the “craving desires” that already plague
them and contribute to their obsessive tendencies; they are the only two characters within the
novel that Gaskell refers to as suffering from “monomania.”

93
Mary is the only one in the novel who correctly discovers that her father, not Jem, is the
murderer. However, her discovery is not dependent on speculation but rather on the fact that she
has access to data that no one else possesses. She is the only one who knows that her father was
in possession of the piece of paper that had been used as wadding for the gun. Thus, her
discovery is dependent on her own experience, not conjecture and therefore she remains both
epistemically and morally virtuous.

134
will indulge indeed in the pleasures of suspense – not yet the serious pleasures of the mid-
century but rather the guilty pleasures of an earlier epistemology

135
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Creator Walters, Darby Jean (author)

Core Title Infectious feelings: disease, sympathy, and the nineteenth-century novel

School College of Letters, Arts and Sciences

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Degree Program English

Degree Conferral Date 2022-08

Publication Date 07/19/2024

Defense Date 06/16/2022

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Tag contagion,disease,Elizabeth Gaskell,Harriet Martineau,jane austen,mary shelley,miasma,nerves,nineteenth century,novel,OAI-PMH Harvest,space,Sympathy,Time

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