The Cult of the Invalid: Industrial Underpinnings

Sneha Mantri // In the first part of this three part essay, I examined the Enlightenment origins of “nervous illness” as a reaction to the development of rationalist scientific development. “Nerves” and neurasthenia challenged medicine’s increasingly mechanistic view of the body, and of illness as the breakdown of the body’s machinery. In this section, I will turn to the flourishing of the cult of the invalid in the wake of 19th century industrialization.

Nineteenth-century medical history is marked by leaps in empirical and experimental knowledge, particularly in the field of neurology. From Broca to Hughlings Jackson, early neurologists turned their attention to the physical underpinnings of neurologic disease. Their detailed description of gross anatomy were supplemented by the work of Purkinje, Golgi, and Ramon y Cajal, who stained and examined brain tissue under the microscope, describing for the first time the neural networks that are now understood to comprise the primary organizational unit of the nervous system.


Brouillet, A Clinical Lesson at the Salpetriere.

Yet in the midst of this increasing attention to physical markers of disease, a competing view of illness was growing. Nowhere is this more evident than in the work of Jean-Martin Charcot, often dubbed the Father of Neurology. While Charcot was the first to describe a number of organic neurological illnesses, ranging from multiple sclerosis to progressive supranuclear palsy, he also was a proponent of hypnosis and hysteria. For Charcot, these had a biological basis as firm as that of Parkinson disease, and he built his career on theatrical public demonstrations of “hysterics” undergoing the hypnosis cure. Perhaps the most famous of Charcot’s women – for they were all women – was a fifteen-year-old girl known as Augustine, whose attacks of paralysis became a form of ritualized madness. Augustine’s sexual history was, according to Charcot, the key to unlocking her hysteria: as a child she was raped by her mother’s lover, which Charcot and his followers alleged “was the source of much pleasure which she did not try to conceal” (Richer qtd in Walusinski). (Perhaps disappointingly, the 2012 film Augustine also portrays the title character primarily as a sexual creature, this time manipulating and seducing Charcot to gain special favors.) The new medium of photography captured images of her faints and contortions for widespread dissemination. Thus, “nervous illness” became inextricably linked with the technological drive of the era. When Augustine later refused to be photographed, she was punished by solitary confinement until she finally escaped in 1880.

Over the course of the 19th century, however, the public theater of hysteria transformed into the private, domestic cult of the invalid. Maria Frawley, in her work Invalidism and Identity in Nineteenth-Century Britain, posits invalidism within the Victorian ethos of evangelism, which gained traction in Britain and the United States in the first half of the century. In this framework, the invalid is purified by suffering and gains access to alternate ways of knowing. Others, such as Talcott Parsons, approach the invalid from the vantage of the sick role, either assumed or internalized, as a way to “opt-out” of social responsibilities.

I would like to propose a different reading: that the invalid represents a rejection of both what Arthur Frank calls the restitution narrative and also the progress narrative of 19th century industrialization. The invalid is in a permanent arrest, neither healthy nor dying. In a world that was becoming increasingly mechanized and depersonalized, the obsession with the invalid in 19th century medical discourse represents a rejection of rational empiricism. In this reading, the invalid remains at the fringes of society, her agency ceded to the demands of her illness. Reading invalidism as an imprisonment opens new perspectives on the concept, illustrated by the intellectually disabled character of Maggy in Charles Dickens’ Little Dorrit.

We meet Maggy through the eyes of Arthur Clennam, who encounters her just outside the Marshalsea Prison:

She was about eight-and-twenty, with large bones, large features, large feet and hands, large eyes and no hair.  Her large eyes were limpid and almost colourless; they seemed to be very little affected by light, and to stand unnaturally still.  There was also that attentive listening expression in her face, which is seen in the faces of the blind; but she was not blind, having one tolerably serviceable eye.  Her face was not exceedingly ugly, though it was only redeemed from being so by a smile; a good-humoured smile, and pleasant in itself, but rendered pitiable by being constantly there.  A great white cap, with a quantity of opaque frilling that was always flapping about, apologised for Maggy’s baldness, and made it so very difficult for her old black bonnet to retain its place upon her head, that it held on round her neck like a gipsy’s baby.  A commission of haberdashers could alone have reported what the rest of her poor dress was made of, but it had a strong general resemblance to seaweed, with here and there a gigantic tea-leaf.  Her shawl looked particularly like a tea-leaf after long infusion (Dickens 97).

Maggy’s primary quality, in this description, is of comic relief.  Her tolerably serviceable eye, her good-humoured smile, her flapping frilled cap, and her seaweed/tea-leaf clothing is Dickens at his amused best.  In this, Maggy is a contrast to Amy Dorrit’s serious demeanor.  As presented to the reader, Amy is the ideal Victorian woman; Maggy is merely grotesque.  The accompanying illustration reinforces this: Maggy resembles a gargoyle more than a human being.  Amy Dorrit, on the hand, is a delicate, almost porcelain figure with a sweet expression of saintliness on her face.  Another sharp contrast between the two women is their size.  Bones, features, feet and hands, eyes…every physical quality about Maggy appears enormous, at least to Clennam, and thus to the reader.  Immediately, then, she is a contrast and foil to Amy, who is repeatedly described as “little.”  Yet Maggy’s physical hugeness is deceptive; though she is large, she is also compared to a baby.  Dickens thus uses physical descriptors as evidence of mental state.  Maggy is, in essence, an overgrown baby.

Dickens draws particular attention to Maggy’s eyes, which “stand unnaturally still.”  Maggy’s life, too, stands unnaturally still.  When Amy asks this woman of “about eight-and-twenty” to state her age, Maggy reveals that she believes herself to be ten years old.  Her mental age seems even younger; Dickens specifically notes that Maggy is barely literate.  Maggy, then, has been mentally imprisoned in childhood, even as she has physically grown to adulthood.  Again, this is a contrast to Amy, whom Dickens describes as having “all the manner and much of the appearance of a subdued child” (54).  Amy demonstrates maturity and wisdom that belie her physical appearance, even mothering her own father.  Maggy, on the other hand, displays a curious lack of the adult understanding that should accompany her chronological age. 

To resolve the discrepancy between Maggy’s physical appearance and her mental understanding, Amy proceeds to narrate Maggy’s history for her, in a fairy-tale tone that makes it clear that she is telling the tale not for Arthur Clennam’s benefit but for Maggy’s ears.  Yet Maggy’s interjections resist Amy’s interpretation of the story.  Until this point, Maggy’s words have been mere echoes of Amy’s, turning her into a child-shadow of Amy’s stronger, more mature self.  During the narration of Maggy’s history, however, Maggy contributes more information than Amy does.  Whereas Amy glosses over the abusive nature of Maggy’s grandmother as “not so kind,” Maggy’s broken “Gin…  Broom-handles and pokers” accompanied by physical mimics of alcoholism and beating (Dickens 98), express her situation more eloquently than Amy’s words.

The hospital where Maggy was treated is itself the kind of physical prison that encloses most of the other characters in the novel.  As Amy puts it, Maggy “stopped there as long as she could.”  The image of stopping, never progressing, is indeed one of imprisonment.  Yet for Maggy, the hospital is an “Evnly [sic] place” (Dickens 98).  She remembers it as a place of delicious foods and drinks—“Such Chicking! [sic]” she cries—and implies that her hospitalization was, ironically, the most idyllic moment in her existence.  Amy notices this, too, explaining to Arthur than Maggy had “never been at peace before” she entered the hospital.  In a sense, the hospital, though a prison, is nevertheless a source of liberation for Maggy from her abusive grandmother. 

Maggy undergoes no spiritual journey to come to a greater understanding of herself as an agent of change.  Instead, illness for Maggy is indeed a sort of imprisonment.  The fever has caused Maggy to stop developing at the age of ten.  Just as other characters in Little Dorrit have stopped their psychological growth at various key points in their past, Maggy demonstrates a new type of illness narrative, one of imprisonment.  Like the characters that are bounded by the physical walls of the Marshalsea, Maggy is stuck with the mental development of a child of ten or possibly even younger.

As soon as the narration of her illness ends, Maggy returns to being merely an echo of Amy.  As an active character, she fades as the novel progresses.  Although she appears sporadically throughout the second book, she rarely speaks.  Instead, Maggy seems to accompany Amy everywhere as a silent witness to turning points in Amy’s life, including Arthur Clennam’s proposal.  In her wild joy—weeping, galumphing down the stairs “like a clog-hornpipe,” (Dickens 771) to pass on the knowledge to anyone she meets— Maggy expresses the intense emotions that Dickens cannot depict in calm, sweet, sedate, Victorian Amy Dorrit.  Thus, as the novel turns away from Maggy’s story toward Amy’s, Maggy becomes increasingly important only as an outlet for Amy’s emotions.  Because her illness has caused her to “stop” at age ten, she is re-imprisoned as Amy’s comic shadow, rather than a character in her own right, with adult forms of agency.  Like Augustine, female invalids in nineteenth-century society were both outside society and at its mercy.

Further Reading

Dickens, Charles. Little Dorrit. 1857. Wordsworth Classics, 1996.

Frawley, Maria H. Invalidism and Identity in Nineteenth-Century Britain. University of Chicago Press, 2004.

Olivier Walusinski  Jacques Poirier Hubert Déchy. Film Review: Augustine. Eur Neurol 2013; 69:226–228

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