Cholera and Nation: Doctoring the Social Body in Victorian England (review)

Pamela Gilbert's book on nineteenth-century cholera epidemics in England is conceptualized and written within the now solid tradition of scholarship that crosses literary and historical studies and takes health and illness as its substantive object of inquiry. From Mary Poovey's early work to recent studies such as Rod Edmond's Leprosy and Empire (2007), scholars have fruitfully read literary works for their rendering of health, illness, and medicine, and have explored medical texts through literary tools of analysis. Nineteenth-century cholera—which produced so much literature as well as so much death and suffering—is an especially rich topic through which to intertwine literary and historical methods.

Gilbert analyzes four epidemics: cholera in England in 1831–32, 1848–49, 1854–55, and 1866–67. Thus the book, and the cholera epidemics themselves, span early-to mid-Victorian England, although the work is not structured chronologically. Rather, with the exception of a first chapter on the 1831–32 epidemic year, Gilbert has chosen to treat the whole span of time in each chapter, organized under different analytic rationales—one chapter a case study of an author, another looking at medical conceptualizations of bodies and social bodies, and still another focusing on a particular analytic (race or gender, for example). Many historians will want an equivalent of the first chapter for each epidemic or at least a chapter devoted to the evolving context over these decades. And it is perhaps historians who will be most interested in this first chapter, on the remarkable years of 1831 and 1832.

The epidemic years were clearly key in English political history as well as English medical history: cholera and revolution have long touched each other, historically and historiographically. Gilbert's arguments are certainly about the epidemics' political implications, showing their connections with Chartism, working-class politics, and the formation of the public sphere. She is interested also in changes over these years, not least the shift from the centrality of clerical authority to medical authority when it came to pronouncements about "the public" and the social body. In this sense, this book is a grounded and deeply researched piece of Foucauldian scholarship, a close study of the often abstracted analytical claims about clerical-medical shifts in authority over time.

Medical historiography often does not give either adequate space or expert enough treatment to Christianity, doctrinal implications, and religious history generally. Gilbert's book shines in this respect. She shows us how critical these elements are for most Victorian topics, but especially for historical objects of inquiry dealing with life, death, and bodies. The early pages of Cholera and Nation are filled with the implications of disestablishmentarianism for management of the epidemic, with the politico-religious response of fast days, and with clerical interventions in, and implications of, large-scale illness and death. One of the most fascinating differences between the 1832 and 1848 epidemic of cholera, Gilbert shows us, concerned the clerical response. Though a "fast day" was an almost automatic response in 1832, by 1848 Lord Palmerston declined the option decisively. By 1848, clearly, not the Church but the medical profession had the authority to claim the right to diagnose both bodily and social causes of cholera and to determine what should be done. Yet, in shaping the political significance of the nation's "social body," the Church had a pre-existing place in the state and in the public sphere: as Gilbert argues, the medical profession actively had to shape its place in that sphere.

Another of Gilbert's significant contributions is her analysis of the poor's response to the epidemics. Sometimes ridiculing and openly opposing the fast days, the popular response was not always what might be expected. The "social body" analysis offered here, then, is richly diverse: the book extends well beyond the often limited reach of medical histories into popular and social response...