Allan Ingram and Leigh Wetherall Dickson, eds, Disease and Death in Eighteenth-Century Literature and Culture: Fashioning the Unfashionable

Allan Ingram and Leigh Wetherall Dickson, eds, Disease and Death in Eighteenth-Century Literature and Culture: Fashioning the Unfashionable (London: Palgrave 2016) 290pp. £66.99 Hb. ISBN: 9781137597182

Based on the findings of their Leverhulme Trust-funded ‘Fashionable Diseases’ research project, the editors of and contributors to Disease and Death in Eighteenth-Century Literature and Culture explore the fascinating intersections of health and medicine, literature, and modish culture. One of the real strengths and innovations of the collection is its approach, which investigates the topic on a scale of fashionability, grouping diseases or conditions in a descending order from most fashionable to least, in four gradations which are used to divide the collection into clear parts.

Falling on the side of fashion are ‘Ennui’ and ‘Diseases of Sexuality’, with ‘Infectious Diseases’ and ‘Death’ on the side of the unfashionable. The series ends on the topic of death instead of another disease or condition since death ‘is both the final stage of many of the diseases under discussion and the subject most inviting of fashioning’ (8). Each section contains three essays apiece, with the exception of ‘Ennui’, which contains two. The collection has two major objectives: to explore ‘the borderline between fashionable and the unfashionable, and therefore […] those diseases and medical conditions that tended to waver on the edges of fashion’  (12) and the ‘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’ (3). The collection handles its two stated themes with aplomb and carves out significant territory in the liminal spaces between literature, medicine, history, socioeconomics, and sociology.

The collection begins with Heather Meek and Jane Taylor’s cohesive and compelling essays on ennui, connecting the condition not only to the greater contexts of sentimental literature and the wider ‘assortment of nervous conditions that surfaced in eighteenth-century medical discourse, including hysteria, hypochondria, melancholy, spleen, vapours, bile, fits and nerves’ (14), as Meek puts it, but also to material culture. Taylor astutely notes that ennui as a condition necessarily feeds into and is fed by fashion, arguing that the ‘fashion system required novelties that were transient precisely because they were unsatisfying: fashion was dependent on, and reflective of, boredom’ (41).  This thread neatly connects to the next section, ‘Diseases of Sexuality’, in which Emily Cock’s very skilful chapter on the ‘à la mode disease’ (i.e., syphilis) illustrates that in ‘fashion and disease, time is of the essence’ (57) – that the fashionability of a disease depends heavily on its progression. This is complemented and compounded by Hermann J Real’s chapter on Jonathan Swift’s works about the Great Pox and other bawdy, pathologised topics, and Kirsten Juhas’s essay on male impotence, which argues that its mutable, shifting status (being considered a disorder, but a curable one) led to its qualification as fashionable.

Moving from sexually communicable diseases to infectious ones, Part Three of the collection begins with Hélène Dachez’s essay on Daniel Defoe and the plague, which adds an important qualification to Juhas’s argument: some diseases may have been fashionable because of their shifting or transformative qualities, but a disease could not be too uncertain. The plague, for example, had ‘an enigmatic, elusive, uncertain nature which made it largely resistant to fashioning and to understanding’ (130). Her work is followed by Allan Ingram’s essay on inoculation, a medical practice clearly linked to aristocratic circles, and small pox, a disease at odds with inoculation and therefore relegated to unfashionable circles. Intriguingly, consumption – the subject of Clark Lawlor’s following chapter – is included in Part Three, on the lower end of the fashionable scale. Lawlor opens his chapter acknowledging how fashionable a disease consumption was, but investigates an understudied element of consumption: the unfashionable periods in which to discuss consumption, and the less potent but equally important imagery of consumption which depicts it to be unfashionable.

Part Four, ‘Fashioning Death’, begins with Kelly McGuire’s return to a discussion of inoculation and small pox, this time to position inoculation more firmly as a foil to death. Looking at inoculation not only as a fashionable, upper-class practice but also as one of ‘bodily modification’ (190), McGuire argues that ‘inoculation played a pivotal role in the medicalizing of death in the eighteenth century [and] staged a confrontation with death that granted a measure of agency to patients’ (191). This is followed by Leigh Wetherall Dickson’s essay on suicide in high society, locating it amongst conflicting opinion as a marker of Englishness, a sign of fashionable ennui, and the result of dishonour, unsociability, or moral failing. The final chapter, Helen Deutsch’s analysis of phrenological discourse on Jonathan Swift’s autopsied skull, breaks from the collection’s focus on medicine in literature to discuss the transformative practice of turning a dead body into a public object.

If one small criticism of the collection as a whole may be made, it is that it emphasizes research about Jonathan Swift a little too heavily. Three of the eleven essays use Swift as their main focus, or at least as a major element, with Swift also featuring in a fourth essay. The collection might have been better served by distributing some of that attention amongst two or three other authors or subjects. Another point of note is the exclusion of cancer from their scale of (un)fashionability (the inclusion of which could have potentially rectified the Swift-heavy nature of the collection). While the collection could not, of course, cover every conceivable disease or medical condition, and while the editors and contributors investigate an ambitious and impressive swathe of territory, it is surprising that there is not a chapter or section devoted to portrayals of cancer generally, and breast cancer more specifically. Indeed, cancer threads its way through most of the collection, appearing conversationally in five of the essays. Its repeated mention indicates that the topic possessed sufficient resonance for it to have merited its own chapter or section (especially given the well-known long-eighteenth-century texts like Fanny Burney’s mastectomy account and Maria Edgeworth’s Belinda). On the whole, Ingram and Dickson’s edited collection is an astute and convincing work that sheds much-needed light on the cultural medicalisation processes that populate the pages of eighteenth-century literature.

Abigail Boucher, Aston University