This volume is one of the publications arising out of the Leverhulme Trust research project ‘Fashionable Diseases: Medicine, Literature and Culture, 1660–1832’, which was conducted between 2013 and 2016 by members of the English division at the University of Northumbria and of the History Department at the University of Newcastle. The purpose of the project was to investigate how certain diseases, some of them extremely unpleasant, or even destructive to life, became fashionable during certain periods, as ideas about culture and the valuation of specific modes of living, suffering and dying change. In the period of the project, for example, mental conditions such as melancholy continued, at least in certain circles, to enjoy a high degree of fashionability, as they had since the early seventeenth century, partly because of their association with intelligence and creativity, and subsequently with nerves and sensibility. More physically painful conditions, such as gout, or even some kinds of stomach ailment, such as biliousness and indigestion, could also acquire a fashionable profile, not least because they tended to arise from high living and the means to indulge continually in the finer things in life. Even consumption, a disease that was generally a death sentence, had a high level of social valuation: it was believed not only to bestow a measure of ethereality, and therefore of beauty, on the sufferer, but also to heighten the perceptions and to allow time to approach death with equanimity. Moreover, susceptibility to the disease was associated, as with melancholy, with individuals of heightened sensitivities.
Part of the work of the project has therefore been to explore the different shades of meaning of the word ‘fashionable’ during the period, particularly when applied to disease, and to look at how different fashions within the culture of the time, and how change, both scientific and theoretical, in medicine and its application, fed into those meanings. This work has involved a close reading of, primarily, literature (with the exception of the final chapter in this collection in which it is Jonathan Swift’s skull that is read), supplemented and informed by contemporaneous medical texts, patient narratives and experiences, and literary and visual representations of diseases and patients. Many factors, of course, contribute to the making of cultural meanings. These, in general, include wider political and religious issues, the state of national satisfaction and prosperity, the different preoccupations that succeed each other as the focus of public attention, and the ways such matters are reflected in various organs of public dissemination. We turn to literature as not only one of those organs but also as a product of, and as producing cultural discourse around, disease and death that intersects neatly with fashion and fashionability. Those personalities, too, who come to the fore of public attention, either positively or negatively, can influence cultural meaning, as can more perennial factors, such as diet, popular entertainment, and even climate and weather patterns. Indeed, such factors might themselves be said, in certain circumstances, not merely to feed into the meanings of fashion but actively to fashion them.
This volume has two major themes. It is concerned with the borderline between fashionable and the unfashionable, and therefore with those diseases and medical conditions that tended to waver on the edges of fashion, and with those that remained firmly on the unfashionable side, in spite of being endowed with sometimes fashionable features. But also, to the extent that so much in the project, and in the volume, depends on how different currents within society made sometimes imperceptible changes in cultural and moral attitudes, we are interested in those aspects of a disease that made it capable of being fashioned, of being rendered meaningful, for better or worse, within the social frame and within literary and artistic representation. However unfashionable a disease might be, however gruesome in its symptoms and outcome, there will be an accompanying process of fashioning which, at different times, constructs nuanced social, cultural, satirical, religious, symbolic and, of course, medical significance from the bare facts of its pathology. Sometimes this is not a straightforward process: Jonathan Swift’s use of syphilis, for example, is embedded within a network of points of view regarding gender, class, social conditions and religious duty, so much so that his work remains, as it has always been, controversial and liable to produce very different readings, depending on the preoccupations of the reader. With other diseases, fashioning is more a matter of trying to come to terms with what on the face of it looks like an inexplicable and godless disaster, as with bubonic plague. This is ‘Fashioning the Unfashionable’: how we make some sense of, and indeed live with, some of the most troubling conditions of human existence.
The volume is divided into four sections, each dealing with a discrete group of diseases, organized to proceed from, on the face of it, the most to the least fashionable. Part I, which acts by way of preface, is ‘Ennui’, which, as a form of melancholy, and as having strong associations with a leisured and privileged class, as well as with particular types of sufferer and their lifestyles, is the closest to fashionable in the sense of being a condition to which certain kinds of people might well aspire. This, in a sense, is our control group – that which can be readily perceived as fashionable, as capable of being faked for social purposes, and as the most clearly lucrative for those medical professionals specializing in its treatment. Ennui, too, is readily capable of being fashioned into forms of cultural significance, from a comment on society to the state of one’s soul.
Ennui, like Anne Finch’s melancholy, which she described in ‘The Spleen’ (1709) as ‘Proteus to abus’d mankind’, is read by both Heather Meek (Chap. 2) and Jane Taylor (Chap. 3) as not a single entity but a multiplicity of experiences.1 The ‘problem’ of Meek’s title is that the actual experience of ennui cannot be properly understood from the perspective of physicians who, while not doubting the reality of the condition, can note only the externally generated bodily symptoms. The reduction of a complex emotional and psychological state to a limited set of observable physical responses renders ennui something that can also be performed with a few gestures, thereby allowing for charges of affectation being levelled at the sufferer. On both counts, however, the bodily performance is merely the mimesis of a state of mind that has a complicated relationship with the experience of time and problems of meaning. Therefore, argues Meek, an informed understanding of the genuine severity of an affliction can only be gained by examining attempts to describe the destabilizing effects of ennui by those who have undergone it themselves, and for this purpose Anne Finch, Lady Wortley Montagu and Hester Thrale are all called forward as experts in ennui by virtue of experience. Taylor also examines the struggle to determine and define the exact nature of a condition that is viewed as being both subjective and objective, and how the very word ‘ennui’ contributes towards the difficulty of definition. With reference to Maria Edgeworth’s Ennui (1809), Taylor examines the paradox of a condition that is only definable by the emotive pronouncement of a French word (notably by a member of the Protestant Ascendancy at a time when feelings about Anglo-Irish relations and towards the French were running high) that has no fixed meaning and no English equivalent. Taylor argues for a multiplicity of interpretive strategies when approaching a term that simultaneously invites and eludes definition, one that is situated at the intersection of the fashionable, the political and the medical.
Part II is ‘Diseases of Sexuality’, which are more clearly on the cusp between fashionable and unfashionable, not least because those forms of behaviour that risk bringing about sexual diseases are associated with men, particularly, of a certain kind of fashion. At the same time, actually suffering from a sexual disease involved long and often recurring periods of pain, considerable expense and a degree of social ostracism. Nor was cure ever a certainty. Diseases of sexuality, too, were highly susceptible to being fashioned in terms of social and cultural significance, particularly insofar as they could be regarded as their own punishment for sinful behaviour, or even divine punishment for a sinful civilization. Emily Cock (Chap. 4) considers the relationship between the infection and long-term effects of the disease, and, as in Taylor’s discussion of ennui, examines the implications of how the naming of the disease contributes to the framing of the experience. The styling of syphilis as the disease à la mode, argues Cock, aligns the infection with the importation of the new and the novel, and signifies the illness as being of the moment in such a manner as to belie its long-term effects. À la mode places emphasis only on the present moment and is indicative of a reckless disregard for custom, tradition and heritage. The cure, however, signalled a commitment to the future by submitting the afflicted body of the present to an extended course of treatment, the effects of which were as debilitating as the disease, and the subsequent disfiguring of the body by both disease and treatment served as a constant and present reminder of the sufferer’s past. Cock’s analysis of the complex and competing temporal framing of syphilis turns towards the significance of the watch as an apt illustration of the intersection between time, fashion and illness in relation to the depiction of the poxed female figure in Hogarth’s The Harlot’s Progress and Marriage à la Mode.
Hermann J. Real (Chap. 5), like Cock, examines the detrimental effects of both disease and cure but in the context of how Swift has been fashioned as both impious and impervious to the temporal suffering of syphilitic women. Real examines Swift’s satires The Lady’s Dressing Room and On a Beautiful Young Nymph Going to Bed as a form of preventive medicine, written at a time when Britain was perceived to be at the mercy of ‘The Plagues of Venus’. Real challenges critical attempts to explain away Swift’s scatological themes and motifs in relation to a misanthropic disregard for the social necessity for discretion. He argues that Swift’s graphic descriptions of the diseased female body are the antithesis of the masculine stance of having been fashionably poxed, and are, therefore, an attempt to draw public awareness towards the plight of those infected not only by the disease but also by the appalling after-effects of the treatment. Swift, by addressing the disgusting directly, suggests Real, directs the disgusted reaction back towards the reader in order to advance his literary call for compassion for the victims of insatiable appetites, and also highlights the ineffectualness of purported cures that trade on fears of public exposure and the moral stigma associated with syphilis that ultimately only conspire towards the spread of the contagion and the creation of even more suffering.
Kirsten Juhas’ chapter (Chap. 6) on male impotence as a fashionable subject for discussion also opens with Swift, here the riposte from Lady Mary Wortley Montagu to his On a Lady’s Dressing Room. Montagu’s anonymously published The Dean’s Provocation for Writing the Lady’s Dressing Room suggests that Swift’s voyeuristic gaze is the result of his impotence in terms of sexual and literary performance, and thus begins Juhas’ interrogation of the seventeenth- and eighteenth-century fascination with male impotence, a condition deemed so prevalent that fears for the survival of the nation race were repeatedly expressed. Juhas argues that the widespread discussion surrounding male impotence arose from concerns about the health of the nation as marked by an increase in medical research into sexually transmitted diseases and also from the visible rise in interest regarding divorce proceedings that cited impotency, and thereby the non-consummation of marriage and subsequent lack of legitimate issue, as the primary cause for separation. As well as being the victim of Montagu’s satire, Swift appears to engage in the prevalent literary practice of scopophilia as evidenced, suggests Juhas, in ‘The Progress of Marriage’ and A Tale of a Tub, the former poking fun at a marital mismatch that results in a lack of progeny, and the latter drawing on images of mutilation, such as castration, as an extreme form of male impotence, as a satire on Charles II’s persecution of religious non-conformity, thereby drawing the discussion of impotence into the political arena.
In Part III, ‘Infectious Diseases’, we move into territory that is usually distinctly unfashionable in the sense of the capacity to carry social cachet. Infectious diseases, such as smallpox and the plague, ran well-known courses with largely predictable outcomes. Treatment was often ineffective and suffering was guaranteed, as well as the strong likelihood of passing the disease on to members of one’s family or household. At the same time, such conditions, like diseases of sexuality, allowed considerable potential for being fashioned. Within forms of social discourse and within individual narratives, infectious diseases were capable of interpretation in terms of divine punishment, personal sinfulness or the inexplicable workings of destiny. One exception was consumption, which, while widely recognized as a death sentence, nevertheless managed to develop powerful social and religious resonance because of the nature of its course and of the death it promised. With consumption we find the most conspicuous example of the conundrum of fashionable diseases: something which was virtually guaranteed to kill its victims but which nevertheless had high social value.
Hélène Dachez (Chap. 7), like earlier contributors, examines the correlation between the spread of disease and the health of the nation. The mysterious nature of plague, as represented in Daniel Defoe’s Journal of the Plague Year (1722), makes it largely resistant to understanding and to some extent to fashioning. The function of Defoe’s narrator, H. F., is that of an eyewitness who wanders about the sick body of the English capital while attempting to fashion the mysterious epidemic into a coherent narrative in medical, religious, social and human terms. The elusive nature of plague is further emphasized through rumour (as opposed to objective facts): both act through spreading and contagion, and both resist the narrator’s fashioning power....