The Science of Starving in Victorian Literature, Medicine, and Political Economy

Mangham, Andrew

Last Updated: Sep-26-2022

Galbo, MA, MILS, Sebastian

Primary Category: Literature / Nonfiction

Summary:

Andrew Mangham’s The Science of Starving in Victorian Literature, Medicine, and Political Economy examines how Victorian writers drew upon the era’s medicine and physiology to represent the physical realities of starvation. Wondering readers, at first glance, might ask if starvation can be described in any terms other than a physical experience; however, Mangham argues that prevailing nineteenth-century political economy theorized population growth and food scarcity in ways that radically obscured the corporeal suffering wrought by starvation. Undergirding Victorian-era political economy was the influential work of the British cleric-economist, Thomas Malthus, and the rise of statistics. Malthus’s well-entrenched theories maintained that starvation, or large-scale famine, was a natural (and therefore inevitable) response to overpopulation. “In Malthus’s thinking,” Mangham clarifies, “hunger is the greatest tragedy in human economics: in the worst of times it rises up as a horrible check on those nations whose resources have been overrun by improvident birth rates” (1). These theories further solidified within religious contexts, which produced the peculiar notion of “salutary starvation” (26) or “the providential law of starvation” (30)—an understanding of famine and other disasters as just consequences for exceeding the material capacities of God’s “natural system” (26). Malthus’s theories, imbued with religious interpretations, were pernicious and far-reaching, seeping into how the British government and affluent classes viewed and (mis)understood poverty. Mangham also maintains that Malthus’s theories were augmented by the emergence of statistics during the first several decades of the century, which enabled the government to measure and evaluate epidemiological patterns, demographic data, and other information about human populations (53). He notes that while statistics were used to collect data about starvation, the data were frequently presented in ways that skewed the prevalence of malnutrition, food scarcity, and diseases and mortality rates related to starvation (56). Using a range of literary and primary sources, Mangham underscores that support for statistics was far from monolithic, that for all the scientific certitude that government officials invested in the discipline, there were critics who vociferated about how statistics were often reductive representations of human experience. In other words, masses of tabulated numbers created a cold, mathematical distance between government authorities and those human lives suffering starvation (56–57). Overall, Mangham outlines a bleak picture of Victorian political economy and its views of material privation.

For Mangham, then, one of the most injurious consequences of political economy was its failure to observe starvation (and its manifold health complications) as a material, indeed physiological, experience. As noted, political economists viewed starvation as anything but a form of bodily suffering, using theories instead to explain the naturalness and necessity of hunger and thus blaming the poor, not government and industry, for their problems (31). While political theorists were preoccupied with these explanations, Mangham traces the era’s concurrent developments in medicine that examined the physiology of hunger and digestion. The gastrointestinal research of Italian Lazzaro Spallanzani influenced Victorian physicians, namely John Hunter, Charles Thackrah, George Henry Lewes, Thomas Southwood Smith, and others, who sought to describe the anatomical workings of the stomach and explain the bodily sensations of hunger (36). Against this backdrop, Mangham argues that Charles Kingsley, Elizabeth Gaskell, and Charles Dickens—united in their “antipathy towards Malthusianism” (17)—recognized the power in articulating starvation using physiological terms, and turned to science to limn “. . . the material sufferings of the starving and, more importantly, on detailed analysis of what it means to go hungry and to observe and to write about it in a way that seeks to be truthful” (16). In chapters that individually examine each author’s literary works, Mangham demonstrates how “. . . physiological ideas offered both an alternative way of thinking about hunger and an exploration of the ways in which it might be interpreted” (47). This volume’s close readings of these authors’ various novels, journalism, and speeches reveal that medical science offered a language that could undermine theories that misunderstood human starvation and the sociopolitical conditions that perpetuate it. Kingsley, Gaskell, and Dickens used new science to depict not only physiologically accurate but humanized renderings of the poor.

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When We Cease to Understand the World

Labatut, Benjamin

Last Updated: May-09-2022

Trachtman, Howard

Primary Category: Literature / Fiction

Genre: Historical Fiction

Summary:

When we think of genetics and pedigrees, we expect our traits and characteristics to be passed down in a predictable pattern from parents to children. In his book Far From the Tree , Andrew Solomon labels this transmission from one generation to the next as vertical identity. However, his book focuses on circumstances where inheritance follows what he calls a horizontal pattern. In these cases, the offspring have an inherent or acquired trait that is foreign to their parents. They land far from the anticipated spot under the tree canopy and are dramatically different from their parents. He or she must acquire their identity from a peer group that is outside the parents’ experience. One chapter in Solomon’s book focuses on genius as seen through the lens of the violinist Joshua Bell and his family. Most of us would gratefully welcome a child of genius whether in science, architecture, or music and embrace the apple that landed far from the tree. Reading Benjamin Labatut’s riveting book might cause you to rethink this thought experiment.

Nothing will quite prepare you for the literary world that Labatut has invented. It is a unique blend of fact and fantasy, an incremental layering of fictional conceits on known historical details. A stream of people from history pass through the book, some deservedly famous and others more obscure. But all of them are possessed of genius. All of the characters lived through the turbulent first third of the 20th century when quantum mechanics revolutionized the traditional understanding of physics. They confronted the challenge that this new knowledge presented to the grand view that people had held about how the universe was designed and operated.

The book opens with Fritz Haber, whose research on nitrogen fixation chemical reactions provided the basis for the production of fertilizers, pesticides and explosives. Haber’s work had diametrically opposite effects on the course of history. On the one hand, he enabled dramatic increases in agricultural crop yields and prevented global hunger. At the same time, his discoveries increased the carnage in World War I and yielded compounds that led to innumerable deaths by asphyxiation in the trenches in no-man’s land and, later, in the Nazi death camps. There is Karl Schwarzschild who was able to solve Einstein’s equations in the general theory of relativity while fighting in the German front lines during World War I. He identified the potential existence of black holes, Schwarzschild singularities, long before Stephen Hawking made them famous. Alexander Grothendieck, considered the most influential mathematician of the last hundred years, also passes through the pages of Labatut’s book. After an extraordinarily creative career in which he totally upended established concepts in geometry and number theory and other mathematical fields, he ended up abandoning his life’s work. He devoted himself to Buddhism and, retreating to a secluded village in the Pyrenees, he lived out his last years alone and unrecognized. Erwin Schrodinger is forced to enter a Swiss sanatorium to convalesce from tuberculosis. While there, under the influence of a teenage girl similarly afflicted with tuberculosis, he derives his wave equation and the Psi function to explain the wave-particle duality of light and matter. Even Schrodinger is perplexed by this discovery. He cannot reconcile himself fully to the truths of quantum mechanics and spends the rest of his scientific life trying to unify it with Einstein’s Theory of General Relativity. Finally, towering over the narrative is Werner Heisenberg. He agonizes over the discrepancy between the Newtonian physics that he has learned in the university and what he is uncovering in his research into the subatomic realm. He is overcome in a semi-mystical vision and articulates the uncertainty principle. Heisenberg realized that his matrix mathematics put an end to the stable universe created by the Enlightenment in which everything is governed by rational laws of nature and observable cause and effect.

By focusing on these men (sadly, not a woman among them) of uncommon genius, Labatut vividly illustrates how the gift of deep insight drives intense scientific creativity but also agonizing psychic pain. It is as if the awareness of hidden truths is inextricably linked to human suffering. This summary may sound pedantic and unbearably heavy. Only if you enter into Labatut’s unique literary space will you appreciate the inventiveness and intelligence of this overpowering book, all 191 pages of it. It is well worth the trip.

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Darwin's Hunch: Science, Race and the Search for Human Origins

Kuljian, Christa

Last Updated: Feb-14-2022

Olagun-Samuel, Christine

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Inspired by Stephen J. Gould’s study of Samuel Morton in The Mismeasure of Man, Christa Kuljian’s Darwin’s Hunch traces the story of the search for human origins while apartheid was taking hold of South Africa in the mid 20th century. Following the work of Charles Darwin, biologists and anthropologists of the 19th and 20th centuries were captivated by comparative anatomy, human classification, and the origins of mankind. Kuljian begins her book with the very origin of racialized thought in science: the distinction between monogenism and polygenism. These two schools of thought in the 18th and 19th centuries sought to explain the existence of human difference; the former arguing that all races stemmed from a single ancestor and the latter arguing that different races emanated from different species. Physicians and scientists were at the center of this discourse, creating names for different racial categories while debating whether races were different species in and of themselves. Eventually, well-known physicians and anthropologists created tools to measure anatomical differences between racial groups. Kuljian centers her book on the studies of the physicians and scientists who contributed to academic discourse, including Johann Friedrich Blumenbach, Robert Bloom, Raymond Dart, Hertha DeVilliers, and Phillip Tobias among others.

In the search for the “missing link” between man and animal, South Africa became a living laboratory. Paleontologists, physicians, anthropologists and the like began a search for living fossils after the discovery of the Taung Skull by Raymond Dart. This discovery birthed the search for human origins in South Africa. For many scientists at the time, the living fossil was not only physical evidence of human evolution, but also supporting evidence for presupposed ideas about racial difference, and so “the most interesting specimens [became] the natives”. South African researchers like Robert Broom, Raymond Dart, and Phillip Tobias, among many others, began projects to study the anatomies of the Bantu, Khoikhoi, and other native people of South Africa. Some researchers embarked on expeditions to Bantustans, reserves that segregated the native population, and measured living native communities, others studied “skeletons from graves”, and still others examined “unclaimed bodies from South African hospitals”.

The focus of this work in many ways was also a search for a pure racial type. These studies aimed to quantify racial differences by measuring the “brain size, skull shape, facial features, skin colour, hair texture and bone length” of native people. Other studies were reminiscent of previous investigations of difference, such as the objectification of Sarah Baartman, in that “Dart gave special attention to the external genitalia… and the accumulation of fat on many of the females’ buttocks”.

Kuljian also traces the political history that coincides with this race for human origins by discussing the progression of the apartheid state of South Africa. Jan Smuts, who would later become Prime Minister of South Africa during the time of Dart’s early investigations, was also the president of the South African Association for the Advancement of Science which institutionally funded and supported the search for human origins. He continued supporting this research into his prime ministry, as increasingly “race [became] a national neurosis in South Africa”.

In this captivating look at the personal stories of researchers, their sociopolitical context, as well as the stories of the people they studied, Kuljian dives into the tension between personal beliefs and scientific practice. She examines how bias, politics, and institutions shaped investigations into the search for human origins.

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Mysterious Medicine: The Doctor-Scientist Tales of Hawthorne and Poe

Poe, Edgar Allan; Hawthorne, Nathaniel

Last Updated: Jan-25-2022

Field, Steven

Primary Category: Literature / Fiction

Genre: Anthology (Short Stories)

Summary:

Mysterious Medicine: The Doctor-Scientist Tales of Hawthorne and Poe is one in a series of books called Literature and Medicine dedicated to the exploration and explication of the intersection of the two titled disciplines. This volume, edited by L. Kerr Dunn, looks at the short stories (mostly—it includes one sonnet) of Nathaniel Hawthorne and Edgar Allan Poe from the viewpoint of each author’s use of, and in some cases experiences with, doctors, diseases, and the medical profession. The volume begins with an Introduction that situates the writings within the medical and social milieu of the period (the authors were contemporaneous) and illustrates the way in which the tales reflect the times.

The stories are grouped by author and arranged chronologically. Among the nineteen entries included are “The Minister’s Black Veil,” “Lady Eleanore’s Mantle,” “The Birthmark,” and “Rappaccini’s Daughter” for Hawthorne, and “The Black Cat,” “The Fall of the House of Usher,” “Berenice,” and “Some Facts in the Case of M. Valdemar” for Poe; each entry is preceded by a brief introduction and followed by discussion questions. An extensive list of scholarly references closes out the volume.

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The King's Anatomist

Blumenfeld, Ron

Last Updated: Jan-03-2022

Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

Brussels mathematician Jan van den Bossche, (fictional), single, and fifty years old, is devasted to learn of the death of his lifelong friend, the brilliant (and very real) anatomist Andreas Vesalius. Companions since childhood, shorter, sturdy Vesalius was the outgoing exuberant leader of the duo, snubbing authority, taking risks, and seizing every opportunity to explore the anatomical structure of animals and humans. He constantly dragged the quiet, shy Jan in his exploits.

News of Vesalius’s death sends Jan in two directions. First, he wanders back through many memories: their lives and travels together to Paris, Leiden, Padua, Spain; the rise of Vesalius’s fame in anatomy, medicine, and surgery; and his odd departure from academe to serve foreign crowned heads in France and Spain. Second, it propels him forward on a journey to his friend’s grave on the Greek island of Zante (now Zakynthos), in an effort to comprehend why the notorious skeptic would have embarked on a religious pilgrimage in the first place. Jan realizes that he can forgive Vesalius almost everything, including the theft by marriage of his beloved Alice. But he is incapable of pardoning the bewildering manner of his death.

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Imprimatur

Monaldi, Rita; Sorti, Francesco

Last Updated: Nov-03-2021

Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

In a future 2040, the church is considering the canonization of Pope Innocent XI. An unusual seventeenth-century manuscript is brought to the attention of the authorities and the bulk of the novel is its transcription in full.

The manuscript is the diary of an intelligent, but inexperienced young orphan-apprentice who is working in a Roman hostel in September 1683. The Catholic Church is fighting the Ottoman Turks who have besieged Vienna. Tensions with France are high as that country and its king have long asserted their exemption from Church rule.

A hostel guest dies, and the authorities, suspecting plague, impose a quarantine. The apprentice falls under the influence of another confined guest, Atto Melani, a famous castrato and spy for King Louis XIV of France. Believing that the deceased guest was murdered, they venture out each night into subterranean Rome searching for clues to support their theory and leading them to investigate poisons, panaceas, and political plots. Meanwhile, a physician also confined to the hostel attempts all remedies to prevent plague, while another guest, besotted with astrology, strives to reveal the future, and yet another plays soothing music.

Like a baroque Agatha Christie novel, plausible suspicion is cast upon every guest until the truth emerges and with it many doubts about the saintliness of Pope Innocent XI. The 2040 writer invites the Holy Office to consider the implications of the manuscript before proceeding with the canonization.

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The Conjure-Man Dies: A Mystery Tale of Dark Harlem

Fisher, Rudolph

Last Updated: Oct-01-2021

Duffin, Jacalyn

Primary Category: Literature / Fiction

Genre: Novel

Summary:

A murder mystery set in Harlem of the 1930s. The Conjure-Man, Frimbo, is a reclusive, highly educated soothsayer and fortune teller born in Africa. His Harlem dwelling is a popular destination for local people seeking direction for the decisions that they confront. He takes pains to conceal much about his identity.

One evening, Frimbo is found dead by a client, while a handful of people occupy his waiting room. Doctor Archer, who lives across the street, is summoned to pronounce the death, and the police come soon, led by detective Dart. Then the corpse disappears, and the Conjure-Man reappears alive to the amazement of all.

The investigators use recent technology, including blood typing, to establish that the corpse was not that of the Conjure-Man. Over just a few days, the doctor and the detective work their way through all the possible scenarios to establish the identity and motive of the killer. The ending is surprising.

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Imagining Vesalius: An Ekphrastic, Scholarly and Literary Celebration of the 1543 De Humani Corporis Fabrica of Andreas Vesalius

Ratzan, Richard

Last Updated: Jul-19-2021

Galbo, MA, MILS, Sebastian

Primary Category: Literature / Poetry

Genre: Anthology (Mixed Genres)

Summary:

Richard M. Ratzan brings together scholars and creative writers to celebrate the legacy of the sixteenth-century Flemish physician and anatomist, Andreas Vesalius (1514–1564), and his 1543 landmark text, De Humani Corporis Fabrica (On the Fabric of the Human Body). Ratzan defines the volume as an “ekphrastic collection of poetry, art and short prose” inspired by “the inimitably conceived and executed anatomical woodcuts” of Vesalius’s most enduring creation (xi). Organized by different genres, Ratzan presents introductory essays, ekphrastic works, translations of Vesalius-inspired poems, and detailed note and bibliography sections. The collection does not merely panegyrize but articulates the deeper intellectual import of De Humani’s meticulous anatomical renderings. Sachiko Kusukawa’s introductory essay frames De Humani as a “rhetorically charged polemic and defense” that challenged the European medical institution in two key ways (3). First, it promoted the revival of the “ancient [Greek and Roman] practice of healing based on diet, medicines and surgery,” a bold effort that aimed to resuscitate anatomy and other forms of “hands-on engagement” that had fallen out of favor with Vesalius’s contemporaries (2). Second, De Humani emendated the anatomical descriptions advanced by Galen, a second-century physician who promoted dissection in his Anatomical Procedures and whom European physicians considered an authority (3). This volume captures the fascinating fusion of artistry and intellectual individuality that characterizes Vesalius’s work.

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House on Fire: The Fight to Eradicate Smallpox

Foege, William

Last Updated: Dec-14-2020

Zander, Devon

Primary Category: Literature / Nonfiction

Genre: Memoir

Summary:

House on Fire: The Fight to Eradicate Smallpox is a memoir written by William H. Foege, the physician best known for developing the strategy of ring-vaccination in the eradication of smallpox. Concisely put by New Scientist, his book is “a mixture of memoir, dry public health guide, and riveting tale of an all-consuming mission.”

Though a brief read, House on Fire is comprehensive on each of these fronts. Foege walks us through his life, starting first with his upbringing in Washington state and ending with his role in India as part of the smallpox eradication team there. Notably, the book’s narrative ends before Foege’s tenure as CDC Director in the late 1970s and early 1980s, focusing explicitly on his involvement in combating smallpox. Using his career in public health as a framework, he details how he became involved in global health and how each deployment around the world, whether for the CDC, WHO, or Peace Corps, added to his understanding of contagious disease and of how to better approach smallpox containment. Ever the epidemiologist, Foege does not shy away from including graphs and charts to emphasize his points, especially as they relate to public health data collection. He takes the reader behind the scenes of conferences, regular meetings, and everyday discussions to show the collaboration necessary for global health work, the planning needed, and the good-natured humor and guile it often requires. At times, his interactions seem like a who’s who of American public health: throughout his career, he works with D.A. Henderson, Alexander Langmuir, David Sencer (who also writes the book’s foreword), and Don Francis.

Outside of his own history, Foege acknowledges that in order to understand smallpox and to understand the mission of eradication it is necessary to understand the disease’s complex history. He begins the book with the history of smallpox and details the development of the vaccine from its crude precursor, variolation, to Edward Jenner’s early version derived from cowpox. As he progresses through his story, he notes important historical moments in the battle against smallpox: the development of the jet injector and bifurcated needle as ways to better administer the vaccine, the elimination of the virus first from countries and then whole continents, and, most poignantly, the final cases of smallpox ever recorded.

Though the book necessitates some level of public health knowledge, or at least a comfort with viral disease and baseline public health interventions, it consolidates its role as a basic public health guide at the appendix. In the last pages, Foege reflects on what to do if there were ever a bioterror attack with smallpox, complete with a diagram on how to administer the smallpox vaccine.

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The Estrogen Elixir: A History of Hormone Replacement Therapy in America

Siegel, Elizabeth

Last Updated: May-05-2020

Teagarden, J. Russell

Primary Category: Literature / Nonfiction

Genre: History

Summary:

Elizabeth Siegel Watkins reports on the use of estrogen alone and in combination with progestin for women during menopause and after menopause from the 1890s until the book was published in 2007. She concentrates on the sixty years between 1942 and 2002. The event Watkins uses to mark 1942 as an important moment is the U.S. Food and Drug Administration (FDA) approval for the estrogen product Premarin as hormone replacement therapy (HRT) in women with menopause symptoms. The event she uses to mark 2002 is the release Women’s Health Initiative (WHI) findings that showed estrogen is not the “elixir of life” that many thought it was then.

Watkins builds her story off the trajectory of estrogen use during this sixty-year period, which spanned two peaks followed by two crashes. The estrogens for HRT first crested in the early 1970s before its use dropped dramatically in 1975 on uterine cancer fears. Estrogen use began to rise in the early 1980s on regained confidence from combined use with progestin to reduce uterine cancer risk and from hopes that bone loss could be prevented and even reversed. This resurrection continued through the 1990s as estrogen use during and after menopause became “associated with reduced risk of colon cancer, prevention of tooth loss, lower incidence of osteoarthritis, increase in bone mass, reduced risk of Alzheimer’s disease, and lower rates of death from all causes” (p. 241).

Based on surveys of prescribers and prescription data during this time, Watkins concludes that “physicians who saw menopausal women as patients were…enthusiastic prescribers of HRT” (p. 244). They remained enthusiastic, making Premarin the most prescribed pharmaceutical product through much of the 1990s and until 2002 when the WHI trial was stopped three years early because it showed that HRT failed to produce the expected benefits, and even worse.

Women who took the estrogen–progestin pills, as compared with those in the control group who took placebo pills, increased their risk of breast cancer by 26 percent (relative risk of 1.26), coronary heart disease by 29 percent (1.29), stroke by 41 percent (1.41), and pulmonary embolism (blood clot) by 213 percent (2.13). (p. 271)

The investigators advised clinicians based on these results, that HRT “should not be initiated or continued for the primary prevention of coronary heart disease” (p. 271). Watkins quotes an editorial from the Journal of the American Medical Association that went further in saying that the trial “provides an important health answer for generations of health postmenopausal women to come—do not use estrogen / progestin to prevent chronic disease” (p. 273). HRT prescriptions plummeted.

These clinical inputs into the trajectory of estrogen are just the bare bones of estrogen history. Watkins fills in the story:

The story of estrogen is woven from several strands: blind faith in the ability of science and technology to solve a broad range of health and social problems, social and cultural stigmatization of aging, shifting meanings and interpretations of femininity and female identity, and the pitfalls of medical hubris in the twentieth century. (p. 1)

Watkins weaves these strands into the story of estrogen, which she tells in a chronological fashion, often as the subjects of individual chapters. Some include: the implications of rising feminism; pharmaceutical company promotional activities; the roles of patient advocacy organizations; FDA requirements for patient information about prescription drugs; generational differences in views of menopause; evolving research methods and evidence standards; and cultural shifts and mainstream media influences.

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