Prostrated

Maria H. Frawley, Invalidism and Identity in Nineteenth-Century Britain, University of Chicago Press, 2004; 292 pp., £27.50; ISBN 0-226-26120-4.

One autumn in the early 1840s, Edward Bulwer-Lytton, the politician and prolific author known for his toga histories of ancient Rome and Pompeii, lay on a bed in Malvern, swaddled in a sort of hydropathic toga. He was undergoing the 'water cure', one element of which was to wrap the invalid body in wet sheets. Prolific as he was, Bulwer-Lytton naturally went on to give an account of his cure in an essay first published in the New Monthly Magazine in 1845. In his experience the cure was a revelation, endowing him with 'the first knowledge of health' that he had 'attained since manhood'. He addresses a male readership, exhorting them to devote an autumn to the cure, away from the strife and struggle of business, and away from the masculine ideology of competition and work that was gaining ground in the 1840s. Through the cure men who are prostrated with exhaustion and care will 'return at once to the careless spirits of the boy on his first holiday'.

Bulwer-Lytton is just one of the many seekers after health in the nineteenth century with whom Maria Frawley engages in her excellent study, Invalidism and Identity in Nineteenth-Century Britain. Almost all the fellow-sufferers in her book have written their own accounts of their invalidism, and their particular cases are varied: Maria Frawley writes about the hypochondriac, the invalid tourist and the invalid who lives abroad for health reasons, the Christian invalid whose prime consideration is the longer journey into the afterlife, and those invalids whose journey may simply be an imaginative one, as they gaze out of the sickroom window. As she writes in the introduction, her book is in part a contribution to the field of medical history which focuses upon the patient, rather than upon the physician or medical institution, a field which received its rallying-cry with Roy Porter's 1985 article, 'The Patient's View: Doing Medical History From Below'. Porter exhorted historians to correct a distortion he felt existed when the patient's voice is ignored or dismissed by institutional medicine. Maria Frawley's particular and important contribution is to trace how nineteenth-century invalids exhibit a degree of control and agency over their treatment, and how this often active approach results in opportunities for self-fashioning. The author invokes Ian Hacking's concept of 'dynamic nominalism' in nineteenth-century culture:

Social change creates new categories of people, but the counting is no mere report of developments. It elaborately, often philanthropically, creates new ways for people to be'.¹

Nineteenth-century invalids recognized that society understood them as a category or type with a particular role to play. But it is just this concept of a 'role to play' that both challenges and takes on a double meaning for the invalids in Frawley's study: while the invalid's role was conceived as passive and receiving of care, the actual invalids in Frawley's study are all writing and, in doing so, attempting to make their invalidism active and useful so that it can be regarded as a contribution to a society enamoured of industry and progress. The invalid is preoccupied with a role to play also in the sense of fearing that society may judge him or her not as 'active' but as 'acting'. In her introduction Frawley declares an intention to address the question, 'If incurable but still at work, relegated to bed but still capable of travel, was the invalid something of an impostor?' In a century which trumpeted the virtues of work and industry but which closed with Oscar Wilde's Bunbury, this is a fascinating question, but it is not, after all, one with which this book sufficiently engages. While many other questions are explored, this last is dealt with more by implication. Frawley suggests that Harriet Martineau, for example, argued 'with such intensity for the invalid...