Health, Medicine, and Society in Victorian England by Mary Wilson Carpenter (review)

With Health, Medicine, and Society in Victorian England, Mary Wilson Carpenter has added an excellent volume to the Praeger Victorian Life and Times series. The goal of the series is to provide a set of books that “explain and enrich the simple pictures” of nineteenth-century Britain that exist in the popular imagination, and Carpenter has contributed a book that is a pleasure to read and that provides a well-informed, wide-ranging, and intelligent social history of medicine for the general or student reader. The book delineates in clear and accessible terms how specific illnesses, attitudes toward sickness and health, ideologies of gender and class, and the drive toward professionalization shaped not just the field of medicine but also the diverse conditions of public health. Carpenter skilfully weaves literary and historical anecdotes into her historical accounts, at every turn providing narratives that give non-specialists a way into the period and her topic. In doing so, she models ways in which Health, Medicine, and Society in Victorian England might be used in the classroom, with selected chapters complementing particular topics and texts.

Carpenter covers many of the major health issues of the period and the public health community’s responses to them. Indeed, this is a book as much about how advances in scientific knowledge helped transform all aspects of public health (sanitation, professional credentialing, laws governing medicine, and so on) as it is about the etiology or cultural place of sickness and health in Victorian society. The overall approach of the book is to use specific cases or issues to help us understand what motivated and shaped changes in how Britain sought to preserve and promote the well-being of its inhabitants. Health, Medicine, and Society in Victorian England is therefore primarily organized by infectious disease, its heart comprising chapters on cholera, tuberculosis, syphilis, and smallpox. Two additional chapters deal with deafness and blindness. The whole is bookended by chapters on patients and practitioners: the opening chapter (“Patients and Practitioners in Victorian England”) sets the stage by describing the general conditions of health, illness, and the medical profession in nineteenth-century England, while the final chapter (“Victorian Women as Patients and Practitioners”) focuses on women’s health and women as medical professionals.

While the logic behind this method of organization is not fully clear, the four chapters on individual diseases and the two on what the Victorians called “afflictions” are frequently fascinating. Furthermore—although this remains tacit in the book itself—each provides a different contribution to our understanding of medicine and health in the long nineteenth century. We learn, for example, how the repeated cholera epidemics of mid-century led to radical changes in sanitation and the notion that the state had a responsibility to ensure citizens’ access to clean water (34–54). The chapter on smallpox, by contrast, provides a case study in the difficulties of eradicating a communicable disease even after a method has been scientifically established for its prevention (91–108). The chapter on syphilis provides the occasion for a wide-ranging discussion of how ideologies of gender and sexuality can determine medical understanding and practice (71–91), and the chapter on tuberculosis gives an extended glimpse into the experience of illness during the period (54–71). While the chapter on deafness lets us see the violence that can be done in the name of well-intentioned efforts to “rectify” that condition or to propel members of the deaf community into the mainstream, the chapter on blindness provides a vivid sense of the ways in which the Victorian period “can be seen as a time of real, though limited progress against blindness itself and toward improvement in the lives of the blind” (132).

Each chapter begins with a lovely introductory section that opens with a deftly analyzed literary or historical anecdote and then offers an overview of the issue or disease in question—including, as appropriate, its pre-nineteenth-century history...