The Last Resort

Vladimir Jankovic, “The Last Resort: A British Perspective on the Medical South, 1815-1870,” Journal of Intercultural Studies 27, no. 3 (2006): 271-298.

In this piece on British health travel to the Mediterranean, Jankovic aims to focus on the “…ways in which the medical reasoning and disease etiology impinged on the choice of resorts and regimens, and how such choice meshed with the broad understanding of the region based not only on the geographical and medical documents but also on its changing cultural stereotypes.” (272) He argues that medical opinion explained some aspects of health travel, but not all, as evidenced by the rapidly changing resort hotspots. Though Jankovic asserts that the “career of British climatotherapy… often drew upon the lay rather than scientific consensus and… often passed it verdicts in accordance to the Victorian environmental mores rather than observations, mortality tables or climatological statistics…,” he acknowledges the vital role that the “garb of impartiality and… use of scientific jargon…” played in legitimizing and differentiating different resorts. (272-73)

Explains how temperature was understood to be a determinant of environment-specific physiologies and moralities (environmental determinism) (275)

Some physicians (?) (Sir James Clark) were calling for a more “scientific” approach to health traveling, insisting that “the migration South ought to be based on the knowledge of climatic specificity and the taxonomy of resorts based on morbidity statistics,” but this taxonomy was only beginning to emerge in the 1830s. The prerogative to travel and choice of destination were considered primarily in the context of social factors; “fashion and custom ruled.” (276)

Jankovic touches on the “diseases of civilization,” which, alongside chronic physical illnesses like TB, skin diseases, kidney and liver issues, and cancer, afflicted many health travelers.

Similar to the book on health-seeking in the West by the guy from OU, this article touches on health travel as impetus for territorial/colonial expansion (277)

Science and statistics coming into resort therapy: “From the mid-nineteenth century…[n]ew medical researchers began to seek the attention of the public and the profession by using whatever (quantitative) observations they could put their hands on to dissect climatological hearsay which, in their view, had spurred a facile and unjustified veneration of Southern Europe among the deluded expatriates.” (281)
Use of data to find “truth” in accounts of therapeutic efficacy — attempt to base traveling for health on a scientific epistemology.
“For this emerging group of climatotherapeutic statisticians only a careful attention to meteorological conditions might dispel (or confirm) popular perception and determine which, if any, of the environmental factors could be identified as curative in landscapes of brighter sun, drier air, and warmer breeze.”

Anti-resort therapy science: Discussion of the counter-narrative (exemplified by the work of John Charles Atkinson and Thomas Burgess), which held climatotherapy to be a fad; Atkinson believed that “fresh air” didn’t help cure people and that traveling was dangerous. People were better suited to the climates from whence they came, and modifications in temperature exposure could be conducted in the home by wearing more or less clothes and using heaters, respirators, etc. “Such arguments made understandable the fact that eudiometry (the sciences of measuring the ‘virtue’ of pure air) and chemical analyses failed to discriminate…” between air/water from resorts and from inner cities. Both men used statistics to bolster their arguments against the effectiveness of warm climates on mostly TB. (283-285)

Jankovic uses a controversy over the salubrity of Madeira’s climate to delve into the role of science in determining health benefits/disadvantages. James Mackenzie Bloxam, who traveled to Madeira for health reasons yearly, wrote out against the scientists defaming the resort. “The thrust of Bloxam’s argument was to challenge the validity of scientific methods in identifying the influence of climate on disease, especially when independent means existed by which these influences could be demonstrated… [d]ata might be fictions made up by badly calibrated instruments, and read by people without qualification and experience.” Bloxam was bothered by the total reliance on “meteorological journals and quantitative science,” believing that it should be accompanied by “a clinical picture or patients’ own reports.” “Why use science…[when] common knowledge and personal feeling would suffice? Why call upon meteorologists when patients might be more qualified to pass the climatological verdict?” “Bloxam appealed to tradition and common sense. He thought that the practice of medical travel was sufficiently established to tolerate an ‘expert’ intervention from the outsiders like Burgess.” (288-289)
This is the same sentiment I see in early ads for ES. When science fails to explain therapeutic effects that have been witnessed, the inclination of those who have witnessed it (or just want to believe?) is to question the authority of science in the realm of therapeutics. Is not the patient’s experience a more important component to understanding therapeutic efficacy? Why bring in a scientist to determine the answer to a question that’s already been determined in a much more immediate, real way?

In the end, science (statistics) wins the battle. It gains authority in the field of climatotherapeutics. Despite these misgivings about scientific intrusion, Madeira was obsolete two decades later. Doctors quit sending their patients there. Mounting evidence of the resort’s failure to cure, and even exacerbation of, TB, lent credence to “the quantitative approach to… Mediterranean climatotherapy,” and its propensity to influence “…the medical profession’s judgement on the value of health travel…” “Scientific writers presented their case as a long-overdue audit of a complacent medical opinion that concealed professional idiosyncrasy, anecdotal evidence, and social prejudice. Climatologists staged a putsch using the weapon of impartiality.”

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Water Cures and Science

George Weisz, “Water Cures and Science: The french Academy of Medicine and Mineral Waters in the Nineteenth Century,” Bulletin of the History of Medicine 64, no. 3 (1990): 393-416.

In this piece, Weisz discusses institutional and individual attempts in nineteenth century France to place mineral waters and the therapies that involved them on a biomedical, statistical, and chemical foundation of therapeutic efficacy. He argues that the different way in which spa therapies are understood, utilized, and supported in Europe versus in North America is due to the medical and scientific fields’ support of hydrotherapy in the former, where it is largely absent in the latter.

“Water cures in North America were largely an entrepreneurial activity with limited links to public health authorities and even less to academic medicine.” (394)
He doesn’t cite anything here, so I wonder from where he has gathered this impression. Not that I disagree, but it’d be nice to see where this is discussed elsewhere.

The French Academy of Medicine was put in charge of “authorizing” mineral waters in the 19th century “on the basis of chemical analyses carried out in the Academy’s laboratory.” They didn’t make judgements on the therapeutic efficacy/action of the waters, but just looked at what was in it and compared it to other well-known spots. (396) They added bacterial analyses by the end of the 19th century. (397)

The organization had a branch of inspectors whose job it was to “study scientifically the properties of local waters, to supervise the medical functioning of spas, to suggest improvements to appropriate authorities, and to provide free medical care to indigents.” Their role changed in emphasis from statistics-gathering to the production of original scientific research as the century wore on. (398)

The reports they submitted were gathered, cross-referenced, and published by the Academy yearly (though this was sometimes poorly done and late). “…the aim was to set down information in a logical manner so that correlations among what we would call variables could be made visible. The key question in this case was the extent to which a particular water could be shown to be especially effective against particular diseases or conditions. The goal was to determine each water’s therapeutic specificity…” (398-99)
This is the exact kinda thing that’s going on in climatology. Woot woot!

Weisz spends some time discussing how the reports and the scientific validity they gave the waters were a source of medical authority for the Academy over mineral waters. They advocated for legislation that would prevent people from using the waters without the aid of a physician (this failed — legislation in the early 1860s made waters free to use for anyone).

Spa proprietors were understood as greedy; “the only counterbalance to commercial greed was medical authority.”
Since there was little medical authority in ES, this may explain why the spa industry didn’t take off in America like it did on the continent. Capitalists were permitted to make outrageous claims, and nothing was regulated — they became untrustworthy as medicine scientized. They tried to jump on the bandwagon of scientific legitimacy, but the commercial aspects of their endeavor were too pronounced. Too many unsustainable claims. Trust (particularly of the thin variety, I’d imagine) is a ruthless balancing act. 

The Academy believed that “[t]he prosperity of the spa industry would be ensured if the applications of water cures could be determined scientifically; if a degree of therapeutic specificity were to be established physicians could be made fully to understand the range of conditions for which each water was useful. Explaining the actual mechanisms through which waters acted on the body might be part of this task, but it was secondary to the precise determination of therapeutic efficacy.” (402-3)
This focus on empirical evidence over explanatory theory may have sustained therapeutics through the late 19th and early 20th centuries, but as bacteriology, pharmaceutical chemistry, and other sciences provided a mechanistic (word choice?) explanation, this kind of mass evidence based on “subjective” experience would cease to be as convincing.

Weisz spends some time discussing the difficulties in establishing the extent of therapeutic efficacy; do you take a clinical approach? The variables are very difficult to isolate, particularly for hydrotherapy, where many things are at play. Clinical testing strategies were also in their infancy. The laboratory is another strategy (that became increasingly popular as time wore on), but it is even more reductionist and restrictive. How could you conduct a laboratory test on the community healing aspect of a health spa?

Details attempts at establishing hospitals and laboratories near spa towns, which don’t seem to have happened.

“Chemistry was in certain respects hydrology’ main claim to rigorous scientific status…” though there was some tension between “chemistry adn clinical therapeutics.”

Discusses the case of Forges-les-Bains, a site where chemical testing indicated that the waters had very little mineral content (like Eureka Springs!). The Academy authorized the waters anyway, citing the history of therapeutic efficacy. This was an instance in which, Weisz argues, “…the primacy of therapeutic effects over chemical analysis was affirmed.” (406)
Idea for the conclusion of my thesis (in which I plan to briefly speak on why spa therapies did not take off in America): the fact that Eureka Springs did pretty well despite chemical analyses proving no active agents speaks to the weakness of chemical/hydrological science in the US. 

On data collection, which Hamlin also discusses –
“Collecting data, on the model of public health statistics, seemed in fact one of the few ways to ridge the gap between chemistry and therapeutics by permitting the Academy to utilize inspectors’ reports in order to process these two types of knowledge into data that might conceivably show clear relationships between chemical composition and the healing of particular diseases.”
Hamlin details this same process in England; he refers to it as an attempt, in the Baconian vein, to gather voluminous information about something in order to subsequently construct an underlying theory. I wonder if this was going on in America as well, or if chemistry wasn’t well established enough or interested in different kinds of questions than therapeutics or mineral waters? This could also help shed light on the question of why hydrotherapy didn’t do well in America. If its handmaiden, chemistry, wasn’t organized, authoritative or interested enough to provide solid medical legitimacy, especially considering the active role it played in establishing the science of hydrology in France… there’s no way it could compete with other therapeutic systems. 

Weisz argue that the Academy “helped keep hydrology alive as a scientific speciality in the nineteenth century and invested it with whatever prestige the Academy itself possessed. It also produced a body of medical writing that pretty much confirmed the belief in the efficacy of water cures.” (415)
I don’t think hydrotherapy/hydrology/climatology had similar institutional support. This would be a good argument to make at the end of chapter two; cite the differential in university appointments and commmittees in public health and other government bodies that concern mineral water, hydrotherapy, hydrology, climatology, etc. 

“The scientific effort expended on mineral waters…has in the final analysis been most significant because it has made a clear statement that water cures are valuable enough to be the object of such interest by the medical elite. In so doing, it has helped keep this therapy within orthodox medicine (though far from the center), in spite of the fat that it does not conform easily to the dominant models of scientific explanation.” (416)

Taking the Waters in Texas

Janet Mace Valenza. Taking the Waters in Texas: Springs, Spas, and Fountains of Youth. Austin: University of Texas Press, 2000.

In her survey of Texas health spas centered around mineral springs, Valenza traces the rise, experience, and demise of the many resort-towns that played a role in the settling and development of the Lone Star State. She covers a large swath of time, from the beginning of the nineteenth century up until modern-day, and her narrative style is captivating. Valenza opens up chapters and brings home a few larger themes through her own experiences traveling around Texas and Europe during her research, where she got stuck in terrifying thunderstorms and chatted with a few experienced bathers before whimping out after just a few minutes in the hot, steamy waters.

Valenza comes from a background in geology, and Taking the Waters is a reworking of her dissertation. The difference in methodology was evident from the beginning, and I found it both annoying and refreshing. She went into a lot of depth in a few areas I previously hadn’t put much thought into, a very pleasant surprise. At one point, she discusses how the makeup of the rocks the waters travel through affects their mineral content and thus their taste, color, and effects on the body. Also discussed extensively is the relationship between humans, health, and the environment. What gives a place value to people? Why are particular values attached to certain kinds of places? How do these relationships change, and what sorts of factors facilitate these changes? Such questions lend themselves well to an analysis of why ill people may have trusted spring water and the resorts built around them to improve their health and why that trust may have dissipated.

I was frustrated at times with the cursory coverage of what I took to be pretty important elements in Valenza’s story, particularly when she was dealing with differences in American scientists’ interest in the sciences of balneology (“Because of the imprecise nature of balneotherapy, American scientists generally neglected it…” [10]) and hydrotherapy (“…American medicine disregarded water therapies, as the effects of from mineral water bathing were difficult to attribute to any one factor in a complicated mineral melange.” [146]). Though she gives due credit to physicians’ importance in encouraging their patients to seek health at springs, she does not connect their therapeutic recommendations to discussions in the scientific community. From what I have seen, it is not accurate to say that American scientists were not interested in the science — specifically the chemistry and climatology — behind mineral waters’ and their locations’ effects on the body. I think the role that science played in declining interest in hydrotherapy and balneology is a lot more complex than Valenza attests.

To Read from the Bibliography:

Primary:

Bell, A. N. Climatology and Mineral Waters of the U. S. New York: William Wood, 1885.

Crook, J. K. The Mineral Waters of the United States and Their Therapeutic Uses. New York: Lea, 1899.

Kisch, E. Heinrich. Balneology and Crounotherapy. Vol. 9. Translated by A. Eshner. Philadelphia: P. Blakiston’s Son, 1902.

Pepper, W., and H. Bowditch. “Report of the Committee on Sanitaria and on Mineral Springs.” In American Medical Association, ed., Transactions 31 (1880): 537-565.

Walton, George E. The Mineral Springs of the United States and Canada. New York: D. Appleton, 1883, 1892.

Weber, F. Parkes, and Guy Hinsdale. Climatology: Health Resorts — Mineral Springs. Philadelphia: P. Blakiston, 1901.

Secondary:

Albanese, Catherine L. Nature Religion in America. Chicago: University of Chicago Press, 1990.

Fuller, Robert C. Alternative Medicine and American Religious Life. New York: Oxford University Press, 1989.

Billy M. Jones. Health-Seekers in the Southwest, 1817-1900. Norman: University of Oklahoma Press, 1967.

Lawrence, Henry W. “Southern Spas: Source of the American Resort Tradition.” Landscape 27, no. 2 (1983): 1-12.

Levin, Alexandra. “Taking the Waters.” Early American Life (August 1988): 10-13, 79.

Valenza uses a lot of U. S. Geological surveys, something I haven’t looked into. Should probably see if geologists were talking about the waters, too, and whether their use for human health was a part of that conversation.

 

 

Hydropathic Highway to Health

Jane B. Donegan, “Hydropathic Highway to Health”: Women and Water-Cure in Antebellum America. Contributions in Medical Studies, Number 17. New York: Greenwood Press, 1986.

Checked out through OU’s Library. 


As often seems to be the case, Hyropathic Highway to Health offers a history of hydrotherapy intertwined with one of women’s health. Jane Donegan looks — primarily through a case study of New York practitioners and patients — at how the water-cure movement affected women’s health, their place in the medical profession, and to some extent their position in mid-19th century society as a whole. She does this through concentrating on medical education and theory, the changing ideas surrounding childbirth, and dress reform, comparing the way that hydrotherapists and allopaths handled these issues during a time of national sanitary and health movements.

What I found particularly interesting (and useful) for my research came in the beginning and the end. She describes the rise of sectarian medicine in the first chapter, situating hydrotherapy within the context of the backlash against heroic allopathic medicine of the early 19th century. She mentions the Parisian anatomo-pathological school and the inefficacy (and increased acknowledgement thereof) of age-old therapies as contributing factors toward the public’s distrust of allopathic medicine and turn toward less invasive therapeutical schools. (9-10) Her second chapter offers the best introduction to American hydrotherapy that I have yet to find — Joel and Marie Louise Shew and Russell Thatcher Trall all played important roles in bringing the water-cure to America from the epicenter of its 19th century revival in Austria. Donegan dates its introduction to America as being in the 1840s (3). I do wonder just how constrained to New York her work, and thus her conclusions, are.

Also of interest is the author’s breakdown of the education of prominent hydrotherapists and their communication networks. Many of the initial players (Shew and Trall, for instance) were trained traditionally and converted to hydrotherapeutics after acquiring their MDs. A few of the female practitioners also earned medical degrees from allopathic schools, although this proved challenging because these institutions often did not grant degrees to women. Many others were trained at a hydrotherapy school established in New York by the Nichols’s called the American Hydropathic Institute. It was later taken over by Trall and renamed the New York Hygeio-Therapeutic College. Women were allowed and often counted for almost half of those attending. No mention is made of other schools. Throughout the book, Donegan cites the Water-Cure Journal, whose circulation is claimed to have been ~50,000 (191). I should probably read that, especially as a preliminary investigation has led me to believe it was published on into the ’70s.

Donegan’s detailed descriptions of the various therapies — focused though they are on childbirth — proved extremely helpful in understanding to what my sources from Eureka are referring when terms like “wrap” and “spitz bath” come up.

In the final chapter, Donegen states:

“Essentially unscientific and empirically based, hydropathy, in common with most of the irregular nineteenth-century medical sects, was unable to compete with orthodox medicine once the latter turned away from traditional theorizing about disease causation and began to move toward the clinical, scientific approach which would later characterize modern medicine.” (195)

I take issue with this and instead believe that hydrotherapy remained popular, albeit perhaps to a lesser extent, well into the 20th century. It adopted some changes along the way — emphasizing its more leisurely aspects, and most importantly for my work attempting to incorporate more scientific medicine into its theoretical bases. Perhaps, too, the location in which my study takes place has something to do with the continued interest in the water-cure. I wonder if the southern (or trans-Mississippi) United States experienced the fad later than the Northeast.


TO READ FROM THE BIBLIOGRAPHY: 

*The Water-Cure Journal (1845-1862) — (I think I’ve seen issues of this journal from a later date…)

Harriet N. Austin. Baths, and How to Take Them. Boston: B. Leverett Emerson, 1870.

Anita Clair Fellman and Michael Fellman. Making Sense of the Self: Medical Advice Literature in Late Nineteenth Century America. Philadelphia: University of Pennsylvania Press, 1981.

John S. Haller Jr. American Medicine in Transition: 1840-1910. Urbana, Chicago, London: University of Illinois Press, 1981.

Guenter B. Risse, Ronald L. Numbers, and Judith Walzer Leavitt, eds. Medicine Without Doctors: Home Health Care in American History. New York: Science History Publications, 1977.

Judith Walzer Leavitt and Ronald L. Numbers, eds., Sickness and Health in America: Readings in the History of Medicine and Public Health. Madison: University of Wisconsin Press, 1978.

Alex Berman. “The Heroic Approach in 19th-Century Therapeutics,” pp. 77-86 in ^

*Harry B. Weiss and Howard R. Kemble. The Great American Water-Cure Craze: A History of Hydrotherapy in the United States. Trenton: Past Times Press, 1967.

*Marhsall Scott Legan. “Hydropathy in America: A Nineteenth Century Panacea.” Journal of the History of Medicine 45 (May-June 1971): 267-280.

 

 

The Science of Sympathy

The Science of Sympathy: Morality, Evolution, and Victorian Civilization, Rob Boddice

Rob Boddice makes the argument in The Science of Sympathy that a new, scientific sympathy was developed in the mid- to late-nineteenth century by Charles Darwin and his (mostly) like-minded contemporaries, that this sympathy was at odds with what he terms “common compassion,” or vernacular understandings of sympathy, and that the harbingers of this novel morality employed it to justify research practices, to campaign for political and social action, and even attempted to live by it through their personal belief systems and actions. His goals in advancing such an argument are many, one of the principle ones being that histories of emotion are both valid and informative, offering insight into topics, like eugenics and vaccination, that already have well-developed historiographies. Emotions, Boddice argues, are accessible to the historian through “measur[ing] feelings by actions, by the practices they produce.”[1] By looking at how historical actors internalized ideas about what was sympathetic and what was not, we can “trace… backward, the sympathetic impulse.”[2] In this way, historians can analyze emotional change over time, throwing out the assumption that emotions are static historical actors.

The author often references public interference via the subjection of scientific theories to public opinion, but very rarely does he provide evidence of this outside of the second chapter. The absence of these sources is particularly evident in the chapters on vaccination and eugenics. Boddice’s analysis is thus lopsided; he only considers works written by the scientific actors in his history, citing and analyzing the counter-narratives of public advocates relatively rarely. Instead, he reads between the lines in the sources he does offer an in-depth handling of in order to uncover the strands of common compassion/sympathy he places in opposition to those of the Darwinians. While this is an interesting strategy and is no doubt useful, a fuller portrait in which the lay perspective is more fleshed out would have rendered his argument more complete. The very structure of the book should have reflected this; instead of relegating the discussion of common compassion to a single chapter, it should have been a component of all of them. This would have both provided evidence that this scientific brand of sympathy was indeed new and would also have lent credence to his claim that it was largely unintelligible to the general population.

 

  • What is the connection between morality, sympathy, and emotion? Why can someone write a history of sympathy and call his approach one of history of emotions? What does it mean to write a history of emotions? Does morality (or ethics) have to be based on or associated with emotion? The book seems to be making that assumption, and I’m not sure if I agree. Perhaps my understanding of “emotion” is at odds with Boddice’s? I realize that these topics are discussed at length in the first chapter, but I could use a little clarification.
  • What is evolution’s relationship with socialism? A fair number of Darwinists (Spencer, Wallance, and Pearson, for example) would have identified as socialists, seeing it as the next step in the evolution of morality. In other works I have read, however, it has been argued that evolution by natural selection has very capitalistic undertones of cutthroat, uncaring competition. How can these differing perspectives be reconciled?

[1] Rob Boddice, The Science of Sympathy: Morality, Evolution, and Victorian Civilization (Urbana: University of Illinois Press, 2016), 5.

[2] Ibid., 6.

Science, Medicine & Women in Middlemarch

I started out the summer ambitiously, though I didn’t realize it at the time. Perceiving a declining ability to read fiction, I decided I needed to relearn how to not immediately try and find the thesis in any piece of writing I laid eyes on. What better tome to begin with than one I’d heard whispers around the department as being full of science and gender themes?!

I was in for a treat, but one for which I’d have to work pretty hard. George Eliot is no Jane Austen, and Middlemarch is no light read. In addition to science and gender, Eliot touches on provincial life, religion, ethics/morality, politics (and this one was probably the most prevalent), some technology, love and relationships, change, and so, so much more. While most of the notes I took and things I thought about orbited around a scientific and gendered perspective, I got a lot more from the book than that. And I’ll probably get something entirely different when I inevitably give it another read in a few years.

The book is a study of country life in England, and it is staged in a provincial town. It follows the lives of quite a few of the town’s residents, which is part of the reason the book is so damn long (my copy was 613 pages). I quickly located my favorite character in Tertius Lydgate, a physician from out of town with family in high places and some new, radical ideas about how to treat illness. He trained in Paris, which I found very interesting — at the time (1820s and 30s), the Parisian medical school and attached hospital were training physicians in the anatomo-pathological methodology. Inspired by rational, mathematical methods, these men (one of which is mentioned often in the book, Pierre C.A. Louis) found that patients treated with medicines of the time did not fare any better than those left more or less alone. As a result, these physicians and the students they taught thought it’d be more useful to let diseases take their course. Some of the sick died, after which time the medical men would dissect them and attempt to correlate their diseases/symptoms with internal “lesions,” or abnormalities. In this way, they hoped to discover the true causes of illness and propose new, more effective therapeutic options.

Lydgate’s medical philosophy, and how he feels about the state of medicine in England, reflect his French training. His impetus for entering the profession lay in a perception that the field was in dire need of reform. He found quackery to be indulged by the College of Physicians, “since professional practice chiefly consisted in giving a great many drugs…,” a phenomenon he understands as economically motivated; “…the public inferred that it might be better off with more drugs still, if they could only be got cheaply, and hence swallowed large cubic measures of physic prescribed by unscrupulous ignorance which had taken no degrees.” Lydgate understood medical reform as based around and shaped by statistics, and he would be a unit that, when it became obvious how much more logical and effective his medical philosophies were, would disseminate a more scientific, rational basis for his profession. He would be a medical messiah, converting the ignorant but eager-to-learn populace to a more enlightened medicine, and he would ambitiously begin his journey in a medical backwater — provinciality.

He planned, after concluding his Parisian studies, to “settle in some provincial town as a general practitioner, and resist the irrational severance between medical and surgical knowledge in the interest of his own scientific pursuits, as well as of the general advance: he would keep away from the range of London intrigues, jealousies, and social truckling, and win celebrity, however slowly, as Jenner had done, by the independent value of his work.” (108) Setting himself up in strong juxtaposition against flashy quacks and physicians who touted their powerful, cure-all remedies, Lydgate would let his slow, determined, mathematical, and scientific methods build his reputation for him. People would see the folly in whimsical, drug-based medicine when they realized how ineffectual it was; they would no longer be duped when presented with flashy adverts for cure-all tonics, and they wouldn’t trust a doctor simply because he prescribed the most violent of purgatives. Like his heroes — C. A. Louis, Jenner, Bichat — “Lydgate was ambitious above all to contribute towards enlarging the scientific, rational basis of his profession.” (109) And he was doing so largely with the common good in mind, dotted, of course, with dreams of professional glory.

In addition to presenting what medical reformers hoped for in the mid-1800s, Eliot does an excellent job of portraying the public backlash to such radical, novel ideas. On several occasions, enemies or skeptics of Dr. Lydgate accuse him of unnecessary or unholy dissection. A Mrs Dollop expressed a belief that “Dr. Lydgate meant to let the people die in the Hospital, if not to poison them, for the sake of cutting them up without saying by your leave or with your leave…” A good doctor, she asserts, need not cut open and look inside his patient to know what was wrong. (323) Lydgate’s hesitancy to prescribe medication made many of his patients feel as though he was not performing his duties as a doctor; they were accustomed to being prescribed drugs. How were they expected to get better with none? Were they getting their money’s worth? “…[O]nly a little while before, they [Lydgate’s skeptics] might have counted on having the law on their side against a man who without calling himself a London-made M.D. dared to ask for pay except as a charge on drugs.” (325) In a particularly telling passage in which Lydgate explains to Mr. Mawmsey, a grocer, why he does not prescribe much medicine, the public’s aversion to the idea is made more explicitly manifest;

“For years he [Mr. Mawmsey] had been paying bills with strictly-made items, so that for every half-crown and eighteenpence he was certain something measurable was delivered. He had done this with satisfaction, including it among his responsibilities as a husband and father, and regarding a longer bill than usual as a dignity worth mentioning. Moreover, in addition to the massive benefit of the drugs to ‘self and family,’ he had enjoyed the pleasure of forming an acute judgement as to their immediate effects, so as to give an intelligent statement for the guidance of Mr. Gambit — a practitioner just a little lower in status…” (325)

Not prescribing his patients medicine took the power of opinion and choice from them, and it made them feel stupid for wanting it. The result was defensiveness and aversion; Lydgate’s “logical,” mathematically-based arguments meant nothing to these people, who largely lived their lives by the personal experiences to which they were privy. Lydgate’s imported, academic arguments lay far outside their day-to-day understanding of their world and, more specifically, the workings of their own (and their lived one’s) bodies — they were unintelligible. That is not to say that this vernacular audience was incapable of understanding; far from it, had it been explained to them. But many found no fault with their current doctors’ methods and the agency they enjoyed in the doctor-patient relationship, and they resented intrusion into that trusted dynamic, particularly by someone espousing foreign, abstract theories.

Country doctors already practicing in Middlemarch expressed other, inter-professional anxieties, which often play out between old and new members of a changing order. They harbored prejudices against “a man who had not been to either of the English universities… but came with a libellous pretension to experience in Edinburgh and Paris…” (135), and they found his methods particularly offensive. “It was clear that Lydgate, by not dispensing drugs, intended to cast imputations on his equals.” By setting himself apart in training and practice, Lydgate was isolating and belittling his fellow physicians — he was a threat to their medical authority, and as such, he suffers many ill-founded and assumption-ridden denunciations (and a hell of a lot of negative gossip) throughout the story from his rivals. Thus, Eliot contends with the changing medical field and the popular backlash it elicited — a very useful piece of socio-medical commentary for the nineteenth century medical historian indeed!

Another theme that I found interesting in Middlemarch was that of the role of women. Two main females stuck out to me — Dorothea Brook and Rosamond Vincy. They were foils of one another, and one was clearly what Eliot would have perceived ideal femininity to consist of. Dorothea (amusingly called “Dodo” by her sister, Cecilia) was raised by her uncle and had very firm, religiously-informed ideas about what she wanted from life and how she would carry herself through it. She was always thinking about others before herself, finding ways she could make herself useful to them. Her mind was a sharp one, and she was determined to use it for the common good — or, more immediately, for the good of her husband. She marries an older clergyman, intoxicated with the idea that she would help him to complete his meticulously researched and brilliant magnum opus. After they marry, however, she discovers that his intellectual abilities are lackluster, and his insecurities about them prove a barrier to his allowing her to help him in any meaningful way. She spends a lot of time fully accepting her new position but nonetheless does her best to adapt to her new life and its relative purposelessness. Mercifully, her elderly husband’s fragile nerves lead to his death rather early on in the book. Her logical outlook and altruistic nature render her a perfect supporting character and help her to keep a clear purpose in sight, even if it isn’t the one she initially set up for herself. She is adaptable, sensitive but not over-emotional, sensible, nurturing, and has just the right about of independent flare — not enough to make her disobedient, but enough for her to harbor her own thoughts and impressions, which she shares openly and honestly. She instigates communication between characters who are otherwise unable to come to terms with one another throughout the story, which is facilitated by her constant desire to maintain harmony amongst her friends and neighbors.

Starkly contrasted with Dorothea’s selfless desire to mold herself in a way most helpful to those that surround her, Rosamond Vincy’s perspective is smaller and more self-centered. Her role as a woman is to be supportive, but she directly contradicts her husband’s wishes on multiple occasions, going so far as to foil his plans for relocating to a smaller house without his knowledge. She was raised in the wealthy and well-thought of Vincy family, and spoiled from a young age, is ill-equipped to deal with the change in lifestyle that will accompany marriage to a physician-scientist. Unlike Dorothea, who adapted her lifestyle and purpose to support her husband’s, Rosamond fails to see the value in Dr. Lydgate’s intellectual pursuits and wonders why he doesn’t go into a more lucrative facet of medical practice in order to suit her extravagances. The couple spend a good portion of the second half of the book at odds with one another, but the good doctor takes his duties as a husband more seriously than those of a scientist in the end; he sacrifices his research to support his self-centered wife.

By foiling Rosamond with Dorothea, Eliot presents two different versions of womanhood. Dorothea supports her husband, submitting her mind and enlisting its genius in the wholehearted pursuit of making her husband (both of them) successful. Her second husband is quite successful, and Eliot makes it clear that this is largely a result of the support he receives from his love interest and later wife. Even during the first half of the book when he is hopeless — Dorothea is married to his benefactor and then forbidden to marry him legally — his desire for her positive opinion drives him to achieve. Rosamond, on the other hand, uses her feminine wiles to seduce the young, well-meaning doctor, full of potential as a scientist. After marrying him, she perverts his utilitarian goals, insisting instead that he support her needlessly expensive lifestyle. Instead of encouraging him to do what he loves for the betterment of all, Rosamond insists that he modify his purpose to her own, selfish ones.

Thus, the willful, unyielding woman led to the intellectual death of the noble, utilitarian scientist. I wonder if there isn’t some commentary here on the role that women should play in science — supporters of the real movers and shakers, but certainly not active participants.

Science of the Marginalized: Women in the Age of Scientific Authority

The nineteenth and twentieth centuries have witnessed a transformation in the status of scientific authority. With authority comes power, and with power comes the ability to dictate what is inside the realm of value and acceptability and what lies outside of that constructed space. When scientific disciplines and the respected members of those disciplines began to gain cohesion and recognizable authority, they began to make distinctions between what and who was and was not a part of their research programs and acceptable practices. Members of the scientific community especially susceptible to exclusion were (and are) those who had historically been viewed as outsiders — the most studied groups being women and people of color.[1] In this essay, I will examine how this systematic marginalization at various points in science’s ascension to greater and greater political, cultural, and intellectual authority has changed the way that women have practiced science, paying special attention to how the subjects of study and questions asked by female scientists are centered around different issues than their male colleagues. A similar study on African American science would be equally valuable but would extend the breadth of this essay beyond what I can reasonably discuss.

Maria Mitchell’s successful career as an astronomer spanned the middle third of the nineteenth century and provides an excellent point of departure. Born in 1818, her training and early work took place in the context of a scientific community still quite fragmented; the big names that would contribute to science’s nineteenth century prestige — Charles Darwin, James Clark Maxwell, Michael Faraday, Louis Pasteur — were a development of mid-century. As her biographer Renée Bergland argues, Mitchell established herself as a scientist at a time when “studying science was ‘womanly,’ safely outside the potentially dangerous ideological realms of law or history or theology.”[2]

Lack of ideological authority placed science in a space that, at the time, was acceptable for females to interact within, and Mitchell’s science reflected her acceptance into the community. Like her male colleagues, she scanned the night sky for comets and made her entrance into the astronomical discourse with her discovery of one in 1847.[3] She was given credit for it and felt that she could become “a woman scientist… who could chart out her own course of research,” unlike her heroine Caroline Herschel who constantly diverted credit to her brother.[4] She acquired a job as the computer of Venus and published her astronomical work in various journals.[5] Mitchell was thus a scientist in her own rite, asking her own questions that reflected her relatively secure position within the discipline of astronomy. She needed neither to justify her participation in knowledge-production nor rely on a man’s help to solidify her position in the community.

Major changes were soon to alter the situation for women in science, however. Around the 1860s, America was professionalizing on many fronts, and science too felt this pull. With their newfound authority, professional scientists began to relocate the practice of science to the university — an institution from which women were usually excluded.[6] They also began to construct a view of the scientist that was uniquely male in order to further assert their professional authority. Women practitioners, they thought, would weaken their professional image.[7] Authority, institutionalization, and increased disciplinary cohesion (brought on by advances in theory and methodology) thus gave a particular class of scientist — advantaged by their social and economic position — the power to create spaces of exclusion that left whole sections of the community outside of scientific discourse. This would have profound implications for female scientists and their work in the twentieth century.

One such scientist was Helen Thompson Woolley. Born in 1874, she would face a far different scientific environment than Maria Mitchell. She graduated with a Ph.D. from the University of Chicago before beginning her research on sex differences; her thesis “compared the performance of 25 men and 25 women on motor, sensory and intellectual tests,” and her subsequent research and reviews centered on the same issues surrounding gender differentials in mental capacities.[8] Her frustration with contemporary scholarship on sex differences is evident in Psychological Literature: A Review of the Recent Literature on the Psychology of Sex, where she reviews recent work and, in a powerful and convincing conclusion, repudiates scientifically many of the arguments made by male scientists for why females do not belong in their profession. “There is perhaps no field aspiring to be scientific where flagrant personal bias, logic martyred in the cause of supporting prejudice, unfounded assertions, and even sentimental rot and drivel, have run riot to such an extent as here,” she states in a particularly ardent passage.

Woolley was fighting against the current that was sweeping many of her female colleagues out of science and into domesticity, and her research reflects her tenuous position. She chose to pursue issues related to her gender’s capacity to reason, and by extent to participate in knowledge-creation. Instead of engaging with other lines of inquiry in her field at the time, Woolley chose to hone in on one in which she had a vested interest; the scientific community’s consensus on whether females were intellectually on par with men would have a direct effect on Woolley’s ability to assert her own authority within her discipline. Therefore, because of the authoritative exclusion of her gender from science, Woolley’s research took on a very particular identity — one connected to her identification as a marginalized professional scientist and one based on legitimizing her participation in scientific discourse.

We have now seen how two female scientists’ work differed before and after the marked rise of scientific authority. Maria Mitchell pursued her own interests, relatively unaffected by her role as a female scientist. Helen Thompson Woolley, on the other hand, pursued a research program that attempted to authorize her participation in science; her identity as a woman in science played a central role in her research interests. As the twentieth century wore on, the situation for women in science improved only marginally. Two more scientists’ work will now elucidate how scientific authority has continued to marginalize women and thus inform their research agendas.

Margaret W. Conkey and Janet D. Spector founded a new field in archaeology — the archeology of gender — in 1984 with a groundbreaking article. In it, they highlighted the propensity for archeologists to make gendered assumptions about past populations. Conkey and Spector found that archeologists maintained gender biases when interpreting symbolism and explaining divisions of labor and social hierarchies, and their solution was to begin “a systematic program of feminist research on questions about women and gender.”[9] While it took seven years for anyone to act on their criticism, conferences began to proliferate in the late 1980s and early 1990s. Alison Wylie links the increasing interest in feminist archeology to “a parallel, and, in most areas, antecedent interest in questions about the roles, status, and contributions of women in archeology.”[10]
In this late twentieth century scenario, female archeologists drew attention to the gender biases rampant in their field. This kind of research was different from Helen Woolley’s in that it did not attempt to legitimize the female in general as a potential authority within a discipline; while female archeologists still suffer from unequal treatment in academia, they had at least affirmed their right to be there (more or less) by the 1980s. Conkey and Spector did, however, wage war against the gender biases still inherent in archeological analytical techniques, pointing out that contemporary methodologies were problematic. Perhaps they pursued these research interests because, as women within a scientific framework that was still masculinized in method, they remained outsiders. The authority of male archeologists, so ingrained in the profession, was still implicit in the way that archeology is practiced. While the role of women in science has improved overall, the barriers to equitably assigned intellectual value have remained strong, though often implicit.

Thus, while scientific authority has come with many benefits, it has also provided the impetus for marginalizing some with effects on the kinds of research they conduct. While I by no means am attempting to make the deterministic argument that all women in science have conducted gender-influenced research — that would be over-simplistic — I am, however, asserting that scientists’ work is profoundly impacted by the socio-scientific environment in which they practice, and the marginalization that has resulted from centralized scientific authority has had implications for some women’s work. I think this idea could be further researched and expanded to include other groups on the fringes; perhaps a comparison of the work produced by scientists occupying different positions in the institutional hierarchy would prove fruitful. In any case, as we have seen, different levels of authority from various time periods have produced distinct research agendas. For women scientists, mounting scientific authority has not always resulted in their work being taken more seriously, and it has left a distinctive mark on their research.

[1] By studied, I mean in the discipline of the history of science. These are two obvious examples, but the list goes on and on: those with disabilities, with alternative religious orientations (even as science’s power was eclipsing that of religion), homosexuals (i.e., Alan Turing), foreigners (some more threatening than others), etc.

[2] Renée Bergland, Maria Mitchell and the Sexing of Science (Boston: Beacon Press, 2008), xvi.

[3] Ibid, 53.

[4] Ibid, 114.

[5] Ibid, 155.

[6]Ibid, 156-157.

[7] Renée Bergland, Maria Mitchell and the Sexing of Science, 174.

[8] Katharine S. Milar, “An Historical View of Some Early Women Psychologists and the Psychology of Women,” Classics in the History of Psychology Special Collections, accessed November 18, 2016, http://psychclassics.yorku.ca/Special/Women/characteristics.htm.

[9] Alison Wylie, “Doing Social Science as a Feminist: The Engendering of Archaeology,” in Feminism in Twentieth-Century Science, Technology and Medicine, eds. Angela Creager, Elizabeth Lunbeck, and Londa Schiebinger (Chicago: University of Chicago Press, 2001), 24.

[10] Ibid, 25.