Tentative title: Doctors, Surgeons, Nurses, and Apothecaries: Elizabeth Gaskell and the

Medical Profession

Abstract -

In Victorian England, healthcare, mortality rates, issues of cleanliness and sanitation

became a central concern for reformers, politicians, and writers alike. With the advent of

progress in the form of industrial revolution, railways, periodical press, and scientific

temperament, the medical discourse too took several turns in the long nineteenth century.

Critics like Sally Shuttleworth have pointed out the ways in which this onset of ‘modernity’

was associated with diseases, since the public was not able to keep in pace with the rapid

changes that took place. Thus, these markers of modernity were inadvertently connected to

diseases, physical and mental while death remained a commonplace event in the society.

Therefore, the role of medicine became quite significant in this period, especially with

the growth of scientific temperament in the early nineteenth century. With the invention of

stethoscope, microscope, and later X-rays, and the assimilation of science with medicine in

this period saw major shifts in the conception, analysis, and treatment of diseases. This era

also marks the change in the doctor-patient relationship which acquired an objective distance

in terms of engagement with the disease and the diseased body. The increasing

professionalization of healthcare also gave way to the change in the social position of doctors

and nurses, which rose albeit slowly and not without conflict with the values of society.

It is within this context that Elizabeth Gaskell’s fiction seeks to engage with this

conflict, looking at ways in which her characters like Mr. Harrison in Mr. Harrison’s

Confession seek to establish themselves in a profession that is rife with competition (from

fellow practitioners and newly emergent trends) while Mr. Hoggins from Cranford with his

uncertain social status is constantly admonished by the society of women for whom rank, and
honour precede other social conventions. In Ruth, the fierce competition between the doctor

from London and the doctor at Wales is revealed at the event of Bellingham’s first illness.

Towards the final part, one sees Ruth, a fallen woman is engaged in nursing and reclaiming a

position of respectability in the society and her illegitimate son Leonard is apprenticed to a

local doctor. This multi-faceted representation of doctors and health workers is scattered

across the oeuvre of Gaskell’s fiction which is also supplemented by her knowledge of the

medical world through her uncle Peter Holland, who practiced in London.

This dissertation project seeks to look at Gaskell’s engagement with the medical

world of Victorian England and move on to the representation of men and women working in

medicine in different capacities, the ways in which the doctor-patient relationship is

constructed, and the newly emerged scientific temper finds its place in her work. It also aims

to look at Gaskell’s ideas of social reform that inform her understanding and representation of

these characters.

Research Questions –

1. How did the markers of modernity and progress affect the discourse of illness in

Victorian England?

2. What were the new advents in science and technology that assimilated themselves

into the field of medicine in the early nineteenth century?

3. What were the changes in the doctor-patient relationship in the nineteenth century?

How do these changes find their place in the literature of the times?

4. How do gender and class dynamics come into play in the role of men and women in

the medical field?

 5. Where does Gaskell stand in terms of the depiction of her doctors, nurses,

apothecaries etc? Does the issue of healthcare constitute in her agenda of social

reformation?

6. What are the narrative strategies that Gaskell employs to describe death and disease?

How does she capture and respond to the emergent changes in the field of medicine?

7. How do the ideals of religion, faith, and morality affect Gaskell’s healthcare workers?

How does her own position as a dissenter affect the relations of care that constitute

the doctor-patient relationship?

8. How does Gaskell employ health as a social issue? How do her own interactions with

various people associated with the field of medicine inform her understanding and

depiction of her characters?

9. How does death affect the person administering care to the patient in Gaskell’s

fiction? Can we establish ‘affective assemblages’ in relation to the doctor-patient

relationship in the author’s fiction?

Proposed Methodology –

The dissertation project seeks to look at the various medical theories, statistics of diseases,

mortality rates, and medical reforms of the long nineteenth century and analyse how Gaskell

responds to the contemporary ideas on health and medicine and builds upon them to facilitate

her own narrative with regards to the profession and push towards social reform. The primary

method that would be utilised is close textual analysis vis-a-vis the discourses to look at

Gaskell's portrayal of issues of health and medical practitioners in general. For the

corresponding statistical data, such as reports on sanitation, bills on medical reform, mortality

rates and the number of doctors, online archival resources from the British Library shall be
employed. The study shall also take into consideration both erstwhile and contemporary texts

on medical theories and literature in order to examine Gaskell's fiction.

Keywords - medicine, social reform, diseases, care

Annotated Bibliography:

Caldwell, Janis McLarren. “Introduction: Romantic Materialism.” Literature and Medicine in

Nineteenth-Century Britain: From Mary Shelley to George Eliot (Cambridge Studies

in Nineteenth-Century Literature and Culture, Series Number 46), Cambridge

University Press, 2004, pp. 1–24.

In this chapter, Cladwell states that in the first half of the nineteenth century,

‘romantic materialism’ formed the double vision of the doctors and poets. Arguing that these

romantic materialists understood the world through the book of nature and the book of

scripture, she attempts to trace the genealogy of ideas inherited by Darwin and his

contemporaries prior to the publication of The Origin of the Species. Furthermore, she

problematizes Michel Foucault’s notions of the birth of the clinic by arguing that despite

British doctors took their medical training from France, they were inspired by German

philosophers, thereby making a compelling case for the presence of the ideas of German

transcendentalism and romanticism within British society. However, she does not lay much

emphasis on the notion of the medical gaze of the doctor (health worker) and its relationship

with the author seems to be coloured by Rothfield’s assumptions about the same.

Cole, Thomas, et al. “Narratives of Illness.” Medical Humanities: An Introduction, 1st ed.,

New York, USA, Cambridge University Press, 2014, pp. 169–86.

In this chapter, Thomas Cole and others look at ‘pathography’ which they classify as a

subgenre of biography and autobiography. They trace the lineage of pathographical narratives

in the twentieth century and look at the ways in which narratives of illness have a potential to

become stories with their own narrative strategies. They also argue that personal experiences,

when written down, have a potential to become fictions that constitute metaphor, image,

archetype, and myth. Furthermore, they do a close reading of four narratives of illness: Oliver
Sacks’s A Leg to Stand On, William Styron’s Darkness Visible, Lucy Grealy’s

Autobiography of a Face, and Aaron Alterra’s The Caregiver.

Dragojlovic, Ana, and Alex Broom. Bodies and Suffering: Emotions and Relations of Care,

Routledge, an Imprint of the Taylor & Francis Group, Abingdon, Oxon, 2018, pp. 1–

42.

In their Introduction, Alex Broom and Ana Dragojlovic argue that suffering is not

relegated to the patient alone, rather, it functions as an affective assemblage that affects the

caregiver (doctor, nurses, etc), and the family of the patient in different ways. Locating care

in the relational context of suffering, they further argue that the phenomenon is governed by

various factors such as class, gender, geography etc. They build upon the ideas of Deleuze

and their predecessors in medical humanities to challenge the existing theories of suffering in

case of medical professionals while also trying to efface the dichotomy between the caretaker

and the one who receives medical care. This is demonstrated in the first chapter of the book

entitled Who’s suffering? Professional Care & Private Suffering where they interview

medical professionals from Australia who are engaged with cancer patients. Strictly

dismissing the phenomenon of ‘compassion fatigue’ that is often associated with workers in

the healthcare sector, they also look at the gendered nature of the distribution of the duties of

care, especially in the case of nurses (who are mostly female and are socially obligated). The

study engages with theory of affect to further explore the relations of care within the realm of

the hospital.

Furst, Lilian. Medical Progress and Social Reality: A Reader in Nineteenth-Century

Medicine and Literature (SUNY Series, The Margins of Literature). Annotated, New

York, State University of New York Press, 2000.

 Lilian Furst traces the development of medicine from its speculative form to the

scientific one in the long nineteenth century. Beginning from the humorial theory of diseases,

she looks at the ways in which science was slowly integrated into the medical profession. She

traces these developments within the contexts of Germany, France, England, and USA and

focuses on the works of pioneers such as Bichat, Louis Pasteur, and others. On the other side,

she also engages with the changing relationship between the doctor and the patient, issues of

sanitization, germ theory, and the development of anesthesia and the conflict between these

new methods and the old ones within the society. The anthology compiles representative texts

about doctors and the medical procedure with works of George Eliot, Flaubert, Trollope,

Bulgakov, etc.

Shuttleworth, Sally, et al. “Introduction.” Progress and Pathology: Medicine and Culture in

the Nineteenth Century, edited by Sally Suttleworth et al., 1st ed., Altrincham Street,

Manchester, Manchester University Press, 2020, pp. 1–24.

In their Introduction, Sally Shuttleworth, Melissa Dickson, and Emily Taylor-Brown

argue about modernity in its relationship with the new pathological conditions that were

identified in the nineteenth century. Employing contemporary sources, they demonstrate the

ways in which markers of progress such as railways, the printing press, the sewing machine

etc were linked to diseases which, in turn, fed the discourse of the ‘national pride’ of the

country whose citizens were afflicted with physical and mental ailments that was brought by

‘modernity’. The self-referential discourse of modernity thus depended on theories of

medicine and disease in nineteenth century England.

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