Raw Material: Producing Pathology in Victorian Culture (review)

A surprisingly accessible exponent of one of the newer flavors of cultural criticism, Erin O'Connor serves up four connected case studies of how cultural and literary images of pathology interacted in nineteenth-century Britain. For those who know what they are getting into, this is an enjoyable journey into some fascinatingly morbid byways (in her foreword the author tells us of how in childhood she was enthralled, as was this reviewer, by monster- and freak-books) of Victorian culture. The four nineteenth-century case studies, on the surface, could not be more disparate: Asiatic cholera; breast cancer; early prosthetic limbs coupled (loosely) with amputation and phantom limbs; and, finally, freaks and monsters, of both the P. T. Barnum and the pathology-museum varieties. Her arguments about each of these differ, but all are couched in highly literary, constructivist po-mo terms. Usually I find this talk of signifiers, synecdoche, tropes, metonymy, and catachresis to be tedious in the extreme, a finding that I take to be a character defect of my own. In this particular case, however, I was drawn along briskly, if admittedly at times in a pleasant state of confusion, by O'Connor's story of the way in which Victorian physicians and litterateurs alike managed to export and expropriate the language of disease.

My confusion, as a clinician and medical historian, owes no doubt to my own lack of conversancy with the idiom in which O'Connor's, like many another recent author's, book of "body history" is couched. I freely admit that I think of much of this work as the New Intellectual History (NIH for short). It is a genre that basks in a penumbra of social importance: after all, most of the sufferers of the sundry pathologies she describes were hapless denizens of the Lower Orders. But, when I go through this history, and not just O'Connor's, I discover something curious: the sufferers described have no agency. It is ideas that have agency. Thus, "discourses posit," "figurations situate," and "pathology materialized a means of making and unmaking selves that neither presumed nor required a pathology" (this last quote, at p. 19).

What this Newest of the NIH succeeds nicely in doing, however, in a revision of the revisionists, is to go beyond some of the old canards of medicine-as-social-control. In the O'Connor account, compellingly, "feminist Victorian studies [tending to] reproduce analytical paradigms in the name of critiquing them may have something to do with reliance on Victorian culture as both an archive and an origin, a means of doing history as a means of doing theory" (p. 81). She thus rejects the characterization of nineteenth-century breast cancer literature (e.g., that of the Samuels, Warren and Gross) as an "allegory of oppression" (pp. 99 and 237). Rather, "instead of simply reading breast cancer's urban metaphors as signs of medicine's failure to be neutral, [one] reads those metaphors as the place where medicine actively constructed itself as neutral" (p. 100). A gratifying conclusion, this, though one that not all feminist historians will agree with.

Similar judgments are rendered in each of the other three modules of O'Connor's analysis. Perhaps the most enlightening, and certainly the wittiest, of her chapters is the final one on monsters and freaks. Here, for example, we encounter the 739-pound Daniel Lambert. This most famous fat man of the nineteenth century, avers O'Connor, lived on after his death in 1809 "as a kind of thick description, an immensely layered trope for both the sizable convulsions of the modern world and the stabilizing power of weighty allusion" (p. 177). Every chapter is replete with such jeux, barreling the reader along...