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| Miranda Mason Class of 2019 |
When we look back to the Victorians, there is a figure that lurks in the background of almost every story. Often, he is an intelligent man, sometimes a fool who means no harm, and occasionally a cruel beast. This is the Victorian doctor. The world of medicine in the 1800s existed at the cusp of science and folklore, and so the doctor was something between an enlightened scientist and the beaked medicine man of the past. It was not uncommon for doctors to hold views of medicine that we can now assess to be preposterous, and these opinions had been held in high esteem for decades. New ideas, founded in reason, often received harsh blowback from patients and the public. At the same time, patients were often quick to latch onto ideas of simple, yet ultimately ineffective cures, if those cures did not fly in the face of what they assessed to be common knowledge. Modern doctors seemed to represent a shift from the congenial fellow who learned by example and prescribed the same old remedies, to the cold scientific fellow who delved into corpses, practiced vivisection, and analyzed with microscopy. Who was a doctor? A hero or a villain, waiting to be revealed? Victorian literature and history reveal that physicians were suspected of being the best and worst among men, representative of progress and regress alike.
“When a doctor goes wrong, he is the first of criminals. He has nerve and he has knowledge,” claimed Sherlock Holmes in “The Adventure of the Speckled Band.” (Doyle, 1930, p. 270) It intrigues many scholars that Sherlock should say this, for the same would be true of him. He, too, has incredible nerve and knowledge; not to mention, the man who inspired Sir Arthur Conan Doyle for the character was indeed a physician. Dr. Joseph Bell, a professor at the University of Edinburgh, was the “first forensic pathologist,” and a man equipped with the ability to analyze the appearance of a person and reach accurate conclusions. His capability inspired the abilities of Holmes, as did his list of specialties, which included toxicology, chemistry, pathology, and handwriting. He helped to investigate crimes, using his scientific acumen. He was, however, different from Holmes in his personality. He was known for show-boating, but said that he hoped that people saw a better side to him than the side that shone through Sherlock. All the same, being warmer than Sherlock would not have been difficult, but Bell likely still came across as colder than beloved country doctors, such as Mr. Losberne in Oliver Twist. (Rowley, 2003)
It is the idea that a doctor could have the brilliance of Dr. Bell but the cold character of Sherlock that made people worry. For as long as Sherlock played on the side of the angels, the world would be a safer place, but if he ever put his talents to use in crime, he would be unstoppable. It is this concern that Helen Lavën discusses in her essay entitled “Detectives, Doctors, and Degenerates.” Her essay explores the common Victorian fear of degenerate geniuses. This idea developed with flawed post-Darwinian ideas of devolution. Some reasoned that if man had come from primitive beasts, man could become a primitive beast again. (Parrett, 2012, p. 75) There are great flaws in the theory of devolution, particularly that species evolve as a population, not as individuals; however, evolution was misunderstood by many, and the possibility that man was headed downhill worried them greatly. (Lavën, 2013, p. 2)
Criminals were labeled as degenerate, thought of as men who gave in to beastly desires that remained after eons of evolution. In a way, this makes sense. After all, the drive to survive and reproduce certainly could be the cause for theft, murder, and rape. The fear that a man could not be fought off like a beast of the field when he pursued these things was obvious in pop culture of the time. Lavën proposed that Sherlock Holmes might have served as “a consoling figure for… anxieties about crime,” but that his “eccentric behavior and uncanny degree of familiarity with the criminal underworld” might have undermined the comfort he could provide. (Lavën, 2013, p. 3) Sherlock seemed as though he could too easily become the people he investigated. When the game was afoot, Sherlock knew how to track criminals only because he knew how to think like the beast he hunted. Clearly, crime fighting was exciting to him, not because he would serve justice, but because he was too smart to be occupied by anything else, save for drugs. If Sherlock had no crimes to solve, and no drugs to take, how much boredom could he bear before beginning to plan the perfect crime, as a mental exercise? Dr. Jekyll and Mr. Hyde raised this question as well. If a man became so intelligent and yet so numb to the need to push down degenerate wild urges, would he destroy society? Could doctors become numb to the world and think they had the right to play with it? Dr. Jekyll released Hyde only because he delved into science so far that he became obsessed with a possibility with no moral concerns.
If Sherlock or another great mind, such as Dr. Bell, were to give in to degenerate desires, no one could catch them. Many feared that this had already happened in the Jack the Ripper murders. Of all the suspected professions, physicians were one of the most often accused of being the Whitechapel killer. John Williams, Francis Tumblety, Alois Szemeredy, Roslyn D’Onston, Alexander Pedachenko, Thomas Neill Cream, and Montague John Druitt were all suspected of the killing, and most were doctors, while a few were wrongly noted as doctors by the investigators at some point. (Ryder, 1996) The medical profession became the focus of investigation because it was suspected that only someone with medical knowledge could have known how to remove specific organs from the bodies of the victims. The importance of wielding a knife was emphasized in this theory, and “the image of the predatory doctor drew on… prejudices… that had been encouraged by… anti-vivisectionist lobbying in London.” (Lavën, 2013, p. 6) Vivisection was the title given to the operations performed on animals in order to help doctors to better understand physiology and practice treatments. This was just one case of public discomfort with the actions of medical professionals.
The concern that, by gaining knowledge, doctors used deconstructionist thinking so much (just as Sherlock did in his investigations) that they may not take societal boundaries seriously anymore, was in many ways justified. Doctors were often at the forefront of movements that seemed an assault on society’s standards. It is strange to think, but the man who first traced an outbreak of cholera to the source, thus creating the field of epidemiology, was dismissed time and again when sharing his findings. This was Dr. John Snow, whose studies are chronicled in The Ghost Map by Steven Johnson. Snow was a researcher, who improved anesthesia and served Queen Victoria in one of her many bouts of childbirth. He used the scientific method to practice anesthesia until he had it down to an exact science that could be depended upon, rather than the coin flip of life and death that surgery could often be. He used this same determination when working to find the cause of cholera, which plagued London, especially in the 1850s.
The tale of the medical detective John Snow is representative of the positive side of Victorian medicine. He, like Sherlock, did not fit congruently into society. He was quiet and bookish, often locking himself in a lab to work under the microscope or test a theory. He was known to test his anesthetic on himself, starting a watch, exposing himself to fumes, and waking up to see how long the anesthetic had worked. He was certainly eccentric, and was not comfortable jumping on the bandwagon of societal ideas. At the time of his research on cholera, the main theory of disease was the miasma theory.
Miasmatists believed that the cause of disease was stench. Famously, it was said that “All smell is disease.” In the overcrowded city of London, when disease broke out, it was believed it was due to smelly conditions, such as overloaded cemeteries and overflowing cesspools. This was not good for sanitation, but it was a fear of smell that worsened the situation. To be rid of the smell, the city developed a sewer system that would take fecal matter from homes, and dump it into the Thames. Unfortunately, in one neighborhood, this sewer had a break that leaked some matter into the same lines which transported drinking water to the neighborhood water pump. This was the source of a huge outbreak of the waterborne disease, cholera, in 1854. Before this outbreak, Dr. Snow had published some case studies suggesting that cholera was spread via water, but reviewers had said the papers “[Furnished] no proof whatever of the correctness of his views.” (Johnson, 2006, p. 75) Miasmatists had very little proof of their theory, but it was widely accepted, while theories like Snow’s were frowned upon for challenging the conception that so many claimed was true. Thus, Snow realized the importance of finding definitive proof that would convince society of the true path of the disease. When the 1854 outbreak occurred, hundreds of people around Soho died in about a month. This outbreak was Snow’s chance, so he went door to door asking about the lives of those that died, figuring out what they had in common. In the end, he found it was the water pump on Broadstreet. Removing the handle of the pump drastically reduced the number of cases. Even then, many people still doubted the truth of his claims. Although this medical detective’s work succeeded in the reduction of cases of disease, it wasn’t until he had died that the tide turned in his favor.
The background noise of the cholera outbreak is demonstrative of why the public was so slow to listen to new ideas from a doctor. It was not uncommon for doctors to share any quack idea that came to mind. In the newspapers, almost every physician that published produced a different idea of how to treat the same disease. One editorial stated “If the doctors who write to the papers would agree in their prescriptions for cholera, the public might feel grateful for the trouble taken, but… we are puzzled and alarmed at the risk we run in following the doctors’ contradictory directions.” (Johnson, 2006, p. 50) Indeed, most of the recommended cures were unsatisfactory, but that was not so surprising, as most doctors were performing bad science experiments, if they included science in their methods at all. Snow commonly wrote to newspapers to explain the fault of such doctors, not that it changed the vehemence of foolish opinions.
The behavior of some of these doctors was very much like that of Dr. Candy in The Moonstone by Wilkie Collins. Dr. Candy, thinking he knew best for others, drugged a character, who then performed actions outside of his own knowledge. It was not that Dr. Candy or any other doctors meant to cause harm, but that they did not know better. They had a hint of knowledge, which gave them authority, but didn’t question their own intuition enough to see faults in their theories of disease and treatment. Dr. Candy’s assistant, Ezra, says that Candy had “done great mischief… but [had] done it innocently.” (Collins, 1999, p. 354) All the same, this was another bit of damage done to the reputation of physicians. Perhaps all doctors weren’t degenerate, but they could certainly be foolish and unreliable. This attitude of the public hurt the credibility of heroic doctors, such as Snow.
There was a much more sinister source of Victorian suspicions against doctors as well. Real doctors were decided guilty of murder. More than one physician was accused of poisoning, but the most famous was the Prince of Poisoners, Dr. William Palmer. He was put on trial in 1855 for the poisoning of John Parsons Cook, a winning gambler, who fell ill shortly after a big win. Once he fell ill, Cook was placed under Dr. Palmer’s care. He died, but only after accusing Palmer of poisoning him. Cook was one of many people who were connected to Palmer, fell ill suddenly, and died. Palmer was in severe debt, and used these circumstances to gain financial capital or get rid of the cost of living (i.e. fewer mouths to feed). There were at least 10 other examples of people in Dr. Palmer’s life who fell in this manner. Before he was considered a suspect, Palmer sabotaged a part of the autopsy that would be used to test for poison. The trial became a debate about modern toxicology, in which Dr. Alfred Swaine Taylor had to defend his field to ensure that Palmer was brought to justice. The defense claimed that Taylor’s claims were self-serving and biased, and the prosecution countered that Palmer had medical expertise that made him an exceptionally good poisoner. In the end, the jury founder Dr. Palmer guilty, but not before the new science of toxicology was placed in a position of ridicule, and a doctor was found guilty for committing the very act that doctors are supposed to swear against. (U.S. National Library of Medicine, 2005)
Even the most well-meaning doctors took part in a trade that was considered despicable by the public, yet another reason doctors seemed cut off from society. To prepare to take care of living people, medical students must learn gross anatomy and practice certain aspects of care upon a cadaver. Traditionally, only those who had been condemned to death would be dissected, but after reforms in the 1820s, fewer people were being convicted for crimes punishable by death. There were also many more people training to be doctors. This led to a body shortage, so medical schools needed to work around the law, by making arrangements with body-dealers. These people would collect bodies from the streets, where paupers died regularly. They would also buy bodies of the poor from undertakers, dig up fresh bodies, and deliver corpses to hospitals in darkness. In fact, the bodies of pregnant women, stillbirths, and young infants were the most highly valued commodities. It was all about what made better doctors. (Hurren, 2011)
Meanwhile, in 1827, “Mary’s Ghost,” a poem by Thomas Hood, expressed the popular attitude toward the trade in bodies. Therein, the dead girl’s ghost expresses sorrow to her lover that her body has been dug up and dispersed to various strangers. The idea of one’s family members being dug up and cut to pieces was not a popular one, but for the most part, the common victims were the poor, who had no advocate to defend them. This activity was recognized, but rarely prosecuted, though some body-snatchers were put on trial in scandalous affairs. It was not until after the infamous Burke and Hare murders, in which people were killed to be sold, that reform in 1832 led to greater legal access to cadavers and allowed people to donate their bodies to science. All the same, there was still the ugly connotation in the minds of many that doctors played with dead bodies, cutting them apart, and thus losing some human empathy. (McCracken-Flesher, 2011)
Perhaps the most disheartening behavior a doctor exhibited, without directly killing, was the establishment and maintenance of a terrible asylum system to deal with madness. Doctors who took to psychiatry were the ones who helped build a system in which mental illness was measured by docility instead of true sanity. Treatment only changed from one form of cruelty to another as “the use of mechanical restraints such as manacles and muzzles was steadily phased out in favour of 'moral management', although solitary confinement and straitjackets continued to be used.” (Marsh, 2005) In fact, asylums were so terribly kept, that in “The String of Pearls,” Sweeney Todd uses one as the way of disposing of boys who find out his secrets. It was simple to force someone into an asylum, where they would be trapped for life. In that story, a doctor comes to inspect the asylum and hardly takes the time to consider it before bonding heartily with the asylum manager in an office, far from the patients who may have received better treatment if the doctor had attempted a true inspection. (String of Pearls, 1847)
Clearly, doctors had many cases against them in the Victorian Era. The public always had some reason to be wary of doctors, and no doubt this made it difficult to improve society. People were so used to hearing about the incredibly pompous, incompetent, and cruel doctors, that they were hesitant to trust new progress made in medicine, for it seemed that doctors were capable of some of the worst things. At the same time, for every Dr. Palmer, there was a Dr. Taylor. For every doctor accused of being Jack the Ripper, there were more doctors helping with the investigations. There were men like Dr. Candy, who made foolish mistakes out of pride, but there were also men like Dr. Snow, who put himself at risk to find the truth. Though Dr. Jekyll found a place in the world of the Victorians, he was a doctor who used science to the detriment of others, who represented the idea of degeneration and devolution. There were plenty that used science to serve others well, as an act of progress and evolution as a society. The doctors were at the two extremes of the spectrum because they “were the only scientifically trained people who could have been called on.” (Odell, 2006, p. 100) They were best equipped to do both good and evil.
Over time, doctors would regain trust from Victorians. Reform movements made it easier for doctors to do research within legal means. The betterment of peer review made medical science more stable and easier to access. Doctors became leaders to change asylums into safe places. Public funds were used for “investigation of communicable diseases,” and shifted from “mere involvement in reform to a state system of medicine.” (Robinson, p. 210) In “An Address On the Progress Of Medicine In the Victorian Era” given in 1897, Mrs. Garrett Anderson (a female doctor and the President of the East Anglian Branch of the British Medical Association) concluded that doctors “should do our best so to educate public opinion that the true value of [scientific methods of research] should be generally recognised, and that the demand for it should no longer be restricted within the narrow limit of the world of science. sic” In fact, she argues, doctors must find ways to relate their research to the public to serve people more effectively. Doctors of the Victorian Era would need to recover their reputation as a profession so as to make the most effective progresses in the future. The old suspicion of medicine would need to fade, to let in light and longevity.
References
Anderson, G. (1897). An Address on the Progress of Medicine in the Victorian Era: Delivered before the East Anglian Branch of the British Medical Association on May 27th, 1897. British Medical Journal, 1(1900), 1338.
Collins, W. (1999). The moonstone. Ware, Hertfordshire, UK. Wordsworth Editions.
Doyle, A. C. (1930). The Complete Sherlock Holmes (Vol. 2). Doubleday Books.
Hurren, E. (2011). Dying for Victorian medicine: English anatomy and its trade in the dead poor, c. 1834-1929. Springer.
Johnson, S. (2006). The ghost map: The story of London's most terrifying epidemic--and how it changed science, cities, and the modern world. Penguin.
Lavën, H. (2013). Detectives, Doctors and Degenerates: Sherlock Holmes and Jack the Ripper.
Marsh, J. (2005). Health & Medicine in the 19th Century. Victoria and Albert Museum.
McCracken-Flesher, C. (2011). The doctor dissected: a cultural autopsy of the Burke and Hare murders. Oxford University Press.
Odell, R. (2006). Ripperology: a study of the world's first serial killer and a literary phenomenon. Kent State University Press.
Parrett, A. (2012). The Medical Detective and the Victorian Fear of Degeneration. Formal Investigations: Aesthetic Style in Late-Victorian and Edwardian Detective Fiction, 4, 97.
Robinson, B. (2010). Victorian Medicine—From Fluke to Theory. BBC History. British History in depth: Victorian Medicine.
Rowley, C. (2003). Sherlock Holmes: The True Story. Retrieved November 14, 2017, from https://www.youtube.com/watch?v=YIfghkHsj4o
Ryder, S. P. (1996). Jack the Ripper: Suspects. Retrieved November 19, 2017, from http://casebook.org/suspects/
Stevenson, R. L. (2004). Dr. Jekyll and Mr. Hyde. New York, NY: Bantam.
Sweeney Todd: The string of pearls. (1847).
Visible Proofs: Forensic Views of the Body: Galleries: Cases: Toxicology in the dock: Alfred Swaine Taylor and the William Palmer murder trial. (2014, June 05). Retrieved November 19, 2017, from https://www.nlm.nih.gov/visibleproofs/galleries/cases/taylor_image_2.html
Miranda Mason, of Corinth, Ky., is a junior McConnell Scholar with an individualized major in Medicine and Society. She also studies political science and biology.