Did the Novelist Anticipate the Neurologist?: The Enigma of George Eliot’s The Lifted Veil

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Credit for the first full clinical description of that fascinating subtype of epileptic fit called the complex partial seizure is regularly assigned to John Hughlings-Jackson (1835–1911) on the basis of papers he published in English medical journals from 1875 to the turn of the century.¹ Hughlings-Jackson himself, punctilious to a fault about acknowledging his predecessors, noted that certain other clinicians, especially French students of epilepsy, had partially anticipated his insights regarding complex partial fits.² But there can be little question that, particularly in the Anglophone literature, his studies of the entire spectrum of complex partial phenomena were pioneering efforts, and indeed, as works of clinical description, they remain unmatched today. We remain indebted to Hughlings-Jackson, justly regarded as one of the founding spirits of English neurology, for the comprehensiveness and sensitivity with which he studied the objective but especially the psychologically rich subjective aspects of the partial aura (the introductory phase of the seizure, the details of which the patient can frequently retrieve after the fact and disclose to others). These subjective experiences can include extraordinary distortions of time and memory such as déjà vu, of emotion, and of consciousness, including a phenomenon famously christened by Hughlings-Jackson as the “dreamy-state.” The latter involves a condition of bifurcated or (to use the clinician’s own term) “double consciousness” in which the patient during the fit attends simultaneously to a complex hallucinated scene and to his actual environs, generally discriminating the two and maintaining some awareness that the former is subjectively generated and not based in reality. So compelling and pithy was Hughlings-Jackson’s description of the “dreamy state” that his phrase has been adopted as valuable clinical shorthand by modern neurologists including at times non- Anglophone ones.³

Given Hughlings-Jackson’s achievement, it is all the more surprising that a major English writer of fiction should have published, some two decades before that clinician issued the major papers in question, a novella portraying a man afflicted by precisely the kind of “psychological” epileptic fits the clinician would later elucidate. I refer to The Lifted Veil, a novella published anonymously in August 1859 by Marian Evans Lewes, who had already published one novel under the pseudonym George Eliot and who would go on to achieve renown as a novelist under that name. This is not to say that there did not appear, both before and especially after Hughlings-Jackson’s medical work, other literary depictions of certain fragments of this provocative epileptic syndrome.⁴ However, none of these matches, in my view, the remarkable clinical accuracy of the complex partial spectrum, particularly in regard to the subjective or “psychological” aspects rendered by George Eliot in The Lifted Veil. Perhaps surprisingly, the role of epilepsy in this work has been entirely overlooked both by historians of neurology as well as by students of Victorianera medicine and indeed of George Eliot’s work. (However, another work of George Eliot’s, the novel Silas Marner, published two years after The Lifted Veil, features an epileptic whose symptoms have been recognized as such both by neurologists and by students of her work.⁵) This lacuna justifies, I hope, an essay devoted to the manner in which George Eliot developed the topic of epilepsy in her novella and the bearing of this complex and challenging fiction on the history of thinking about epilepsy in the nineteenth century.

There is another reason for bringing George Eliot’s novella firmly into the orbit of nineteenth century thought on epilepsy. As I hope to demonstrate, she not only dealt comprehensively in this work with a species of seizure well before Hughlings-Jackson ushered it formally into the medical literature but also did so using language which is at times disconcertingly close to that which he would subsequently utilize. For example, she includes a description of an epileptic’s developing, within a spell, a split consciousness such that while preoccupied by a “wonderfully distinct [hallucinatory] vision” of a city hundreds of miles distant he does not lose...