Bulletin of the History of Medicine

Mary Poovey works at the permeable membrane between literary criticism and cultural history—these days, a site of active transport in both directions. She brings the insights of a critic of nineteenth-century English literature to those subterreanean transformations of culture that usually escape attention in ordinary historical accounts. She applies those historical insights to works of both [End Page 532] fiction (Disraeli, Gaskell, Dickens) and ostensible nonfiction: essays on political and social topics, like James Phillips Kay’s famous The Moral and Physical Condition of the Working Classes . . . in Manchester, or the official reports of social reformers like Edwin Chadwick. This volume combines revisions of five previously published essays with a sixth appearing here for the first time and two introductory chapters.

By “social body,” Poovey means a set of conventions that came during her period, through a process of “cultural formation,” to define citizenship in a British nation. She is thus exploring, with a cultural historian’s eye to the businesses of defining, labeling, categorizing, representing, and judging, what may be more familiar as the “revolution in government”: the replacement of ad hoc, local management through vestry and magistracy, by a government dedicated to the making and implementing of “policies.” At issue is not so much the conventions themselves, or their variation among genders and races, but how those variations were organized in the emerging “domains”: the “social,” the “political,” the “economic” (and perhaps, one is tempted to say, the “medical”). Poovey’s essays show domain creation and imposition to be a messy business. There are territorial disputes, but relatively few, since the domains are, in the most important ways, congruent with one another.

More important are the contradictions in expectations toward various sorts of persons. The drudgery of textile-mill work may be a moral problem, remediable by the moral influence of one of Thomas Chalmers’s deacons, or it may be a medical problem of exhaustion of the nervous system, explicable in terms of Cullenian physiology. Such is the problem with which James Phillips Kay struggles; on its resolution hangs the proper response to the Manchester Irish during the cholera of 1832: can they be assimilated, or does the factory system (and indeed, political economy in general) need to shift to accommodate them?

While this is not a work of medical history, four of the essays focus on figures prominent in the early history of institutionalized public health in Britain: Chadwick, Kay(-Shuttleworth), and, remarkably, the leader of the Scottish evangelicals, Thomas Chalmers, who has been an invisible figure in the history of public health, though he was enormously influential in delimiting the scope of that medicine. Historians of public health will gain from these essays a better sense of the significance of those men for social and cultural historians, which in turn should invigorate their work by helping to enlarge its focus to the definitions of “public” and “health” as well as to the achievement of a “public health” institution, whose organization and mission are presumed to be unproblematic. Poovey is also concerned with how domain-formation occurs. Medicine is the source of one mechanism, the anatomizing of the social body accomplished in the great fact-gathering expeditions of the social surveyors. At the same time, Poovey’s agenda is broader than the medical historian’s; her points of departure and her trajectories of development in these essays—concerns with racial identity, the response to poverty, gender roles, notions of political participation, or [End Page 533] the morality of markets—are not necessarily those that medical historians will find most important.

Poovey’s reading of British history, of primary and of secondary sources, is both broad and deep, and her analyses stimulating and, dare I say it, liberating. This is not, however, a book for a casual read: despite being remarkably jargon-free, the essays are tough. Ideally they should be read in conjunction with the primary texts under discussion, and they will be inaccessible to the unprepared student. Nor, as a series of essays, does this book pretend to treat its subject comprehensively. Instead, its value will be in helping us think creatively and critically about the questions we ask of the past.