Bleak House: The Social Pathology of Urban Life

i^Bleak House: The Social Pathology of Urban Life* F. S. Schwarzbach Bleak House is a text permeated by medical discourse. The novel's concern with medicine is, of course, a central one. Two of its leading characters are medical men (Woodcourt and Skimpole), and a third, Rick, trains briefly to be one. Its plot revolves around a disease that serves to unite in infection many of its apparently unrelated charaders. Moreover, the physical disease of the novel functions as synecdoche, standing for the general malaise of the body politic of England at midcentury. Dickens brought to the novel a thorough knowledge of Victorian medical sdence. His library contained important medical and sdentific texts, and he had personal connections with leading partidpants in the medical-sanitary reform movement, among them his brother-in-law, Henry Austin, and his one-time neighbor, Dr. Thomas South wood Smith. He was strongly interested in the public health movement from the early 1840s, and in the years immediately preceding the writing of Bleak House was an active member of the Metropolitan Sanitary Assodation. From 1849 he published important artides on medical-sanitary subjeds in his weekly newspaper, HouseL·ld Words.1 This drcumstantial and topical background to the novel is well known. What I wish to demonstrate is not just that Dickens borrows subject matter from medicine, but that he also uses a language of sodal analysis and a model of sodal reform derived from the medical; that is to say, that the ideological structure of the text depends significantly upon the discourse and paradigm of contemporary medidne.2 What emerges, I trust, is an awareness that the often highly praised sodal analysis of the novel is in some sense less than original, conceiving and representing sodal malaise in ways largely borrowed from a body of writings on sodal and sanitary reform with whidi Dickens's audience was quite familiar. Yet in the end this does not in any way diminish the text: its originality * I would like to thank the LSU Office of Research for a Summer Research Grant in 1985, which allowed me the time to pursue a larger study from which this is excerpted. Literature and Medicine 9 (1990) 93-104 © 1990 by The Johns Hopkins University Press 94 THE SOCIAL PATHOLOGY OF URBAN LIFE lies not in this borrowing, but in the novel's critical awareness of its own ideological limitations, and its attempt to transcend them. ΠThe body of writing on sodal and sanitary problems pressing upon mid-Victorian readers was truly enormous. They were inundated by a seemingly never-ending stream of government Blue Books, exposés by free-lance sodal investigators, magazine articles in both the established older journals and the newer, more reformist periodicals like The Lancet and The Illustrated London News, and even reports in the newspapers, which extracted sensational material from government documents and commissioned their own studies as well (Mayhew's pioneering sodal reportage began as a series for The Morning Chronicle).3 In the reform movement and its publications physidans played a leading role, for to them the most urgent sodal problems were at once medical and sodal. This linkage was a necessary one, given the prevailing miasmic model of the etiology of infectious disease: rotting organic matter (i.e., sewage in stagnant water) produced miasma, atmospheric poisons, which were the direct causal agents of disease.4 As early as the cholera epidemic of 1830 the relationship between bad water and fever was widely recognized, yet by the early 1850s nothing had been done to provide London a sewage disposal system. Hence what might have seemed purely sodal and political problems—overcrowding, slum housing, inadequate and polluted water supply—must be addressed if their medical consequences were to be prevented. Thus the languages, programs, and critiques of physidans and reformers interpenetrate eadi other freely. So George Godwin, editor of The Builder, could write of "hotbeds of disease and vice" throughout central London, and call for a power "to deanse and convert" them: the sodal and medical prescriptions are as one.5 What is significant, in fact, is that the medical model did not provide a way of seeing these several spheres as...