Invalidism and Identity in Nineteenth-Century Britain (review)

Robert Louis Stevenson, a chronic invalid, observed that illness exposed "the real knot of our identity, that central metropolis of self, of which alone we are immediately aware"; taking a slightly different perspective, Thomas Carlyle proclaimed that "self-contemplation . . . is infallibly the symptom of disease." These two statements, both quoted by Maria H. Frawley (p. 61), suggest the often conflicting attitudes toward suffering and subjectivity in nineteenth-century British culture, and the ways in which invalidism came to be seen as not just a physical condition but also a distinct identity with access to "special kinds of interiority made possible by suffering" (p. 62). Frawley excels in charting the social boundaries, conventions, anxieties, and self-fashionings of this "invalid identity." She examines the different genres of invalid narrative, drawing upon a wide variety of literature produced by Victorian invalids themselves, including essays, memoirs, advice books, religious and inspirational tracts, confessional literature, and travel guides. Arguing that invalidism offered special kinds of narrative authority, she identifies some of the common (and occasionally contradictory) rhetorical features, assumptions about audience, and attitudes toward sickness and the search for health that appear in this literature. She also seeks to chart the complex meanings of invalidism for Victorian culture, and to explain how the role of the invalid came to be embraced by many nineteenth-century sufferers.

Chapter 1, "Invalids and Authority," is the most useful for the general reader, offering an admirably balanced and comprehensive account of how medical and cultural historians have (or more often have not) addressed the subject of chronic invalidism. Frawley suggests what might be gained by viewing the history of medicine from the patient's perspective, and examines the broader status of invalidism in nineteenth-century British culture. This chapter is more of an overview than subsequent ones, which are divided into the study of narratives written by hypochondriacs, travel accounts of invalids in search of health, consolation literature by evangelical Christian invalids, and memoirs of life in the sickroom. Over the course of the book, Robert Louis Stevenson and John Addington Symonds emerge as particularly interesting and prolific narrators of their own invalidism, though the complex psycho-sexual issues raised in Symonds's memoirs often exceed the boundaries of Frawley's analysis. In many other cases, however, one feels grateful that Frawley has gone to the trouble of reading, categorizing, and analyzing these narratives so that the rest of us may avoid them. She is consistently interesting, and this is all the more impressive as some of her subject matter is not. In particular, the pious narratives of Christian consolation, the majority of which were written by female invalids, do not translate well for a modern audience. What does fascinate is how such tracts allowed invalid women an authoritative voice that frequently circumvented the medical establishment by embracing illness as a higher calling and advising fellow sufferers to depend upon faith alone.

Frawley's chapters frequently address this complex relationship between gender and invalidism—particularly the contradictions between Victorian ideals of masculinity and the passivity of the invalid condition. She also maintains, however, that the problem of passivity extends beyond gender and into broader Victorian assumptions about progress and productivity. On the one hand, invalids were embodiments of inertia. Often trapped in their sickrooms, chronic invalids were by definition outside medicine's "narrative of promise, a trajectory marked by diagnosis, treatment, and cure" (p. 5). They were further separated by their illnesses from regular avenues of employment. On the other hand, many Victorian invalids reinterpreted the relationship between mobility and productivity both through their travels in search of health and through their voluminous writings describing illness and advising fellow sufferers. Further counteracting the equation of illness and inertia, figures such as Florence Nightingale and Charles Darwin seem to have used their invalidism to facilitate their productivity, strategically avoiding social distractions to focus on their busy work schedules.

Ultimately, Invalidism and Identity is most...