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Reviewed by:
  • Tuberculosis and the Victorian Literary Imagination
  • Meegan Kennedy (bio)
Tuberculosis and the Victorian Literary Imagination, by Katherine Byrne; pp. viii + 223. Cambridge and New York: Cambridge University Press, 2011, £55.00, $90.00.

Consumption claimed an outsize effect, physically and culturally, on the Victorian landscape. Scholarly work on this topic, however, has been surprisingly scanty for such a ubiquitous disease. Other than Susan Sontag’s classic Illness as Metaphor (1978) and Clark Lawlor’s Consumption and Literature: The Making of the Romantic Disease (2006), most literary studies of nineteenth-century disease focus on epidemic illnesses such as typhus, and most studies of tuberculosis exclude literary works. Katherine Byrne’s study of Victorian consumption in medicine and literature provides a welcome and valuable survey of the topic.

Each chapter of the book emphasizes the paradoxical threats posed by consumption and its victims. Byrne discusses the dangers of the strong female invalid in Mary Augusta Ward’s Eleanor (1900) and the weak male one in Henry James’s Portrait of a Lady (1881–82); draws on Leigh Summers’s work to examine the much-imitated and much-criticized tubercular ideal in fashion by way of Pre-Raphaelite icon Elizabeth Siddal and George du Maurier’s Trilby (1894); uses Bram Stoker’s Dracula (1897) to argue that the myths around this disease allowed the patient to function culturally as [End Page 738] both vampire and victim; and notes the analogies between tuberculosis and early-twentieth-century warfare in Thomas Mann’s The Magic Mountain (1924) and A. E. Ellis’s The Rack (1958).

The book usefully traces out the relation of consumption to nineteenth-century capitalism. Because discourse around the illness often centered on the literal consumption of goods and services, and because risk was differentiated by wealth, Byrne argues, we should consider consumption as much a disease of capitalism as cholera and typhus, the illnesses more frequently considered threats to public health in an urban, industrial setting. She provides solid readings of Charles Dickens’s Dombey and Son (1846–48) and Elizabeth Gaskell’s North and South (1854–55) to discuss consumption as both a product of and a threat to the capitalist system.

Byrne also offers a particularly strong contribution to the scholarship on nineteenth-century tuberculosis, or indeed nineteenth-century medicine, in her steady attention to the ways in which medical writers might have been influenced by cultural narratives about consumption as much as by their own medical knowledge. Because nineteenth-century physicians knew little and could do less about this disease, Byrne argues, they were vulnerable to the influences of conflicting literary conventions about consumption: that it was a disease of the bourgeois woman and the artistic genius; that it was either hereditary or transmissible, the product of either penurious or luxurious food and fashion; and that it marked out those with frail bodies, those with a delicate mental sensibility, and those who were particularly spiritual or sensual. Byrne’s chapter on the relation between Victorian physicians and the tangled but persistent myths of tuberculosis is a strength of the book and a model of how to work with a copious archive of primary sources little-known to many readers.

Byrne should also be commended for including hard numbers to support her contention that “the number of medical publications about consumption seems to triple between the 1830s and 1840s, the very decade when the disease was in decline for the first time since the Industrial Revolution”—a result, she concludes, not of its “pathological importance” but of “its newly awakening, perceived social significance” (12). Her numbers, however, demand more careful parsing. Setting aside the possibility that such publications might have improved mortality rates (unlikely given that, as Byrne shows, advice at this time was often contradictory and unsuccessful), Byrne’s Appendix B (“Medical publications on consumption”) raises more questions about these figures than it answers. Byrne has included “medical books/pamphlets” listed in the British Library catalog (190). Did she include texts that were only partially about consumption? On lung disorders generally? What of articles on the topic (more likely to be for a specialized audience)? A rough search using the Surgeon General’s Index Catalogue shows...

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