“Hunger Pains: Andrew Mangham, Ph.D., on Medicine & Starvation in Victorian Literature”

Interview by Sebastian C. Galbo, MA, MILS

As the founder and director of the Centre for Health Humanities and a professor of English at the University of Reading, UK, Andrew Mangham, Ph.D., has published extensively on medicine and Victorian literature. His books include Violent Women and Sensation Fiction: Crime, Medicine, and Victorian Popular Fiction (Palgrave, 2007) and Dickens’s Forensic Realism: Truth, Bodies, Evidence (Ohio State University Press, 2016). Earlier this month, Mangham and I exchanged questions and answers via email concerning his most recent book, The Science of Starving in Victorian Literature, Medicine, and Political Economy (Oxford University Press, 2020). For a brief overview of Mangham’s study, please read the annotation in the LitMed Database.

  1. How did you arrive at the topic of your monograph? What led you to research the intersection of Victorian literature, medicine, and political economy?

It was a bit of a circuitous route actually. At the institution where I teach, there is a key research strength in food science and food security. A few years ago, this was highlighted as an area of research focus within the University, and this got me thinking about what it was that the Victorians could bring to the table, as it were, on the question of modern food security. We’re all very familiar with the idea of the starving Victorian pauper, but I wondered what political and philosophical work this idea or image was doing on the ongoing issue of food inequity. This then set me thinking about how nineteenth-century medicine responded to the problem. Some preliminary research taught me that there was a plethora of medico-physiological works on starvation as a material phenomenon. I also noted that this side of the question had been overlooked by modern scholarship, which has tended to focus on political economy as the Victorian science of hunger. What I found, however, is that medicine spoke in very different ways about hunger and—if anything had a bearing on the birth of social problem realism as the genre of the ‘Hungry Forties’—it was this material, medical, scientific focus set against the consequentialist thinking of political economy.

  1. For readers unfamiliar with The Science of Starving, briefly sketch your main contention. Why does your study deserve attention?

My main contention is that, in the long nineteenth century, there emerged a science of starving in which specialists in medicine and physiology spoke about what happens to the body when we starve. The realities of this process were stark and shocking, and they countered the notion, formulated mainly in the works of Thomas Malthus but swiftly adopted as ‘fire-and-brimstone’ gospel by politicians, social reformers, and authors of statutes, that those who starve are intended to do so by nature—that it is only ‘natural’ that famines sweep away large numbers of people. This propagandizing interpretation of Malthus converted the poor into a mass of immoderate and reckless burdens on the State. The physiological focus on starvation as a harrowing condition which affects individuals helped counter the conservative ideology, and it inspired the social problem fictions of Charles Kingsley, Elizabeth Gaskell, and Charles Dickens, which also take individual subjectivities, ways of interpreting poverty, and reactions to social injustices as key points of focus. Taken in conjunction, literature and medicine show us a world in which the well-meaning ideas of Malthus were exploited and warped into something much more sinister; they also show us the ways out of the problems the ideology has posed for us by returning to a consideration of the individual, the connections between people, and the material realities of modern life.

I would argue that the book deserves attention on two major counts. First, it gives us a new context in which to read Victorian social problem fiction—a context in which we have an explanation for the emergence of realism as a socially-aware, politically-driven mode of writing. Looking at the forgotten context of Victorian food science, we see a lot of familiar and unfamiliar narratives in new light. Secondly, the book—and perhaps the most important issue—deserves attention because its questions are still with us. The conservative interpretation of Malthus has fed into and justified neoliberalism—a political approach tried and failed since the 1980s, and now enjoying a resurgence in the UK. At the heart of the neoliberal ideal is the idea that the many cannot be trusted to handle money and that economic responsibility is rightly placed in the hands of the elite few. The idea is that this will lead to a trickle-down effect, where the many will benefit from the successes of the few. The truth, as we see in the bloated account-books of internet trading companies for instance, is that wealth placed at the top tends to stay there, with some individuals now wealthier than some countries. My book can’t tackle all aspects of this issue, but it does show us where the idea of the ‘immoderate mass’ comes from; how it has justified political disenfranchisements of the poor for centuries, and that there is a more humane approach which concentrates on the experiences and the needs of individuals. 

  1. Describe your research methodologies for this book. You use the first chapter to stage the broader historical context, describing the major theories of political economy and medical understandings of hunger, digestion, and gastrointestinal anatomy. Your subsequent chapters then situate medical texts alongside examples of Victorian fiction. What is your larger methodology?

I suppose my methodology could be identified as a kind of new-historicism, where the powers and meanings of literature are best understood when we pay attention to their original, historical and social, contexts. But this isn’t a straightforward process of identifying where an author picks up his or her ideas. I try to read literature as actively involved in the shaping of history; ideas may begin in medicine and/or political economy, for instance, but they are soon transformed and made to do something special when they work their way into works of fiction. What this work is depends on the styles and objectives of individual authors, but it is certainly the case, I think, that ideas become bolder when they are explored in works of fiction. Zola famously had the idea that the novel was an experiment—a trial of ideas and concepts—and I think that whether an author intends it or not, their work tests the meanings, potentials, and limits of ideas within a certain historical timeframe. I therefore think it’s important to read the fiction produced by any time period we are seeking to understand fully, to go back and to see how and why ideas first emerged through the ways they are tested and dissected in the form of fiction.

  1. Some readers might naturally assume a kind of intrinsic rivalry between art and medicine, fiction and scientific rationalism. Yet your book emphasizes that Victorian writers neither snubbed medical science nor regarded it as antithetical to their literary ambitions. Why is it important that these writers transcended disciplinary borders?

It’s important that the field of ‘literature and science’, which has become quite busy in recent years, moves away from the idea of the two cultures—the notion, that is, of warring approaches to interpreting the world. This is a modern idea, forged in the twentieth century, and is not actually representative of the work science or literature does. To those of us who spend any time with the ideas of science and/or medicine, we’re used to seeing how the intellectual work involved here is no less beautiful or imaginative than the ideas of fiction and poetry. Similarly, we can point to authors whose work has all the hallmarks of scientific rationalism. It is important to see how writers transcend their so-called disciplinary borders because this shows us how ideas evolve when they are passed from specialism-to-specialism; it also shows us how ideas were never meant to be confined in disciplines. Appreciating the true interdisciplinarity of how ideas work opens up a world of possible collaborations and curiosity. 

  1. Writers, as you show, were certainly influenced by the era’s medical texts, but were physicians reading the works of these literary figures? In other words, was there a mutual exchange of influence and recognition between Victorian physicians and writers? Were physicians aware of their impact on shaping the literary texts you examine?

Yes, certainly. This question could have formed the basis of another book—volume 2 perhaps. We know that medical figures read fiction—there is a famous account of the physiologist and surgeon Benjamin Brodie reading The Pickwick Papers in his carriage between consultations; other medics saw literature as crucial to the kind of work they did. The surgeon Anthony Carlisle perceived there to be similarities with the progress of illness and/or injury and the progress of a story. He is thought to have written a gothic novel. For other medical and scientific figures, literature was a ‘switch off’ activity. We have accounts, for instance, of Charles Darwin and Richard Owen reading Dickens in the evenings. In later psychological texts of the period, Dickens’s characters are often held up as case studies of complex conditions like dementia. Whereas we have an obvious written record of medicine’s influence on literature (we can look at specialist language working its way into fictional plots), proving the inspirations in the opposite direction is more challenging, but I wonder whether the evidence is less ‘tangible’. I think the centrality of narrative in case studies and accounts of experiments, for instance, owes much to the powerful example of literature; I also think questions of causation, biological determinism, psychological wellness or aberration have their roots in the long social and psychic studies of the novel.

  1. While these writers used medical language to ground their plots and characters in the materiality of poverty, one wonders if these descriptions would have eventually desensitized readers to the shock of starvation’s physical dimensions. That is, did the language of medical science and physiology become subsumed into what later readers may have recognized (and disparaged) as sentimentality? Did the language of physiology eventually lose its trenchancy as it became an established feature of these Victorian writers’ works?

It’s a good question. Certainly, in respect to the long nineteenth century, I think the science of poverty offered something of a stimulant to ways of reading which had become desensitized. We often hear of social-crusade literature, or poverty tourism in the nineteenth century, as intending to jolt the Victorian reader with confrontations from a world they had chosen to ignore, or which their middle-class existences sheltered them from; but by the 1840s, the world of letters, politics, and social reform were overwhelmed with newspaper reportage, government blue books, and philanthropic pamphlets. Writings about the stock figures of the starving mother and child, for instance, were very common and it’s unlikely that these would have had the confrontational power it would be all-too-easy to ascribe to them when read out of context. In the nineteenth century, however, physiology was relatively new; people were used to medicine as the treatment of the sick, and to anatomy as the study of bodies, usually dead ones, but the science of life—the science of the processes of life—was relatively fresh. This new science had new things to say about hunger—how it operates, what causes it, and how it proceeds if it is unchecked. I think this did emerge into something confrontational, something which had a powerful political ballast. I think it still does. 

  1. Readers might consider the extent to which illustrations—in Dickens’s writings, specifically—also worked to visually articulate the language of physiology. For example, John Leech’s illustrations in Dickens’s Christmas Carol depict the children “Innocence and Want.” These child figures are gaunt, shivering, and spectral; their clothes are tattered. Are readers to understand these illustrations as also reflecting Dickens’s broader efforts to draw on medical science to ground material representations of starvation?

Yes, I think so. ‘Ignorance and Want’ was an image I originally intended to include in the book but left it out in the end because it will be very familiar to a lot of my readers. We know that Dickens exerted a pernickety attention to detail when it came to his illustrations and, as John Leech set about creating the engraving, Dickens would have overseen the process closely. What’s interesting about this image is the fact that it is set in London and yet has a mill in the background, which would have been more identifiable with an industrial town like Manchester. This is an obvious nod to the industrial context—how the inequities of the profits of capitalism result in ignorance and want. The image pays particular attention to bodies in a way that echoes how the literature develops what Terry Eagleton has called ‘corporeal materialism’; in the contexts provided by the spectacle of starvation, skinny, gaunt and raggedy bodies spoke a radical, political message against the status-quo.

  1. At the time these writers were drawing on medical science to recalibrate literary representations of starvation and poverty, did the era’s readers and literary critics observe, even minimally, this changing perspective? Did book reviews, for example, detect this shift in language and representation by responding to or critiquing its efficacy? If not, what may have accounted for this critical oversight?

Reader response is a difficult thing to measure, but reviews are an interesting insight. These differed wildly and depended, of course, on the politics of the reviewer and the magazine or newspaper they were writing for. There certainly was an acknowledgement of the social aspects of the literature and some account of the realism as well. I think that the radical qualities of the literature can be seen in just how often it raises the heckles of a conservative reviewer. It was not uncommon, for instance, for authors to take umbrage with the dogged materialism of an author like Gaskell (which is not an entirely accurate summation—she was very much interested in religion, spirituality, and feeling); Kingsley was also taken to task for his focus on bodies—unseemly, some said, in a man of cloth. And Dickens himself was attacked for the unrelenting nature of his focuses on the poor—for his seeming preference for the characters and situations of low life. Not many critics saw this—at the time—as part of a new way of thinking about poverty, but it’s certainly the case that materialism had long been associated with radicalism. Those readers who appreciated these authors often spoke of their truth and their accuracy and I think this is part of a larger, cultural (largely unspoken) acknowledgement of the powers of social problem realism. By the time we get to the next wave of social problem fiction—Arthur Morrison, George Moore, George Gissing—we’re in different territory and there is, I think, a more critical and analytical reflection on corporeal materialities. 

  1. Historians of medicine, political scientists, and literary scholars will certainly note the importance of The Science of Starving. Aside from these readers, what do you want your research to convey to today’s medical students and practicing physicians?

I’m fairly happy leaving medical students and practicing physicians in peace. They do extraordinary work and don’t need me to tell them how to make their work more humane or socially responsible. Politicians, on the other hand, I’m very happy, in the words of Dickens, to ‘fall upon’. The emergence of the far right, the zombie-like persistence of neoliberalism, and general intolerance among conservative politicians are all things which suggest that some of our civil servants might take a leaf out of the book of the nineteenth century. I would love it if my research could convey to some individuals that consequentialist thinking, knee-jerk policies, and political essentialisms have all been tried and tested, have failed, and done irreparable damage. One thing the authors of fiction and the pioneers of science and medicine have taught us is the power of thought—the importance of keeping an open mind and being willing to abandon ways of thinking whose fixedness is preventing us from growing as individuals and societies. We can learn a lot by looking to the past and we need these lessons more now than ever.

  1. Describe your current research project(s). What are you working on these days?

The Covid-19 lockdowns, horrid in most respects, gave me time to think and write. I have just completed a new book entitled We Are All Monsters: How Deviant Organisms Came to Define Us. It will be published in February 2023 by the MIT Press. It’s a study of how nineteenth-century literature and science encouraged us to think about monstrosity as key to understanding the workings of nature. While it’s true that gothic monsters reared up every now and then with a very negative portrayal of monstrosity, it’s also true that the monster came to symbolize a form of difference and diversity which was not the exception, but the rule. My next work will be on accidents and emergencies in Victorian literature and medicine. As I’ve been saying to those who have been kind enough to ask what I’m working on right now, I’m thinking about emergency medicine before emergency medicine. How did we respond to urgent medical cases before ERs and ambulances? How does the idea and treatment of physical trauma allow us to think in new ways about trauma more generally? And how does emergency medicine inspire literature’s dissection of the modern condition?

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