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STUDIES IN MOBILITIES,
LITERATURE, AND CULTURE

Medicine and Mobility in

Nineteenth-Century
British Literature,
History, and Culture
Edited by
Sandra Dinter
Sarah Schäfer-Althaus
Studies in Mobilities, Literature, and Culture

Series Editors
Marian Aguiar
Department of English
Carnegie Mellon University
Pittsburgh, PA, USA

Charlotte Mathieson
University of Surrey
Guildford, UK

Lynne Pearce
English Literature & Creative Writing
Lancaster University
Lancaster, UK
This series represents an exciting new publishing opportunity for scholars
working at the intersection of literary, cultural, and mobilities research.
The editors welcome proposals that engage with movement of all kinds –
ranging from the global and transnational to the local and the everyday.
The series is particularly concerned with examining the material means
and structures of movement, as well as the infrastructures that surround
such movement, with a focus on transport, travel, postcolonialism, and/
or embodiment. While we expect many titles from literary scholars who
draw upon research originating in cultural geography and/or sociology in
order to gain valuable new insights into literary and cultural texts, propos-
als are equally welcome from scholars working in the social sciences who
make use of literary and cultural texts in their theorizing. The series invites
monographs that engage with textual materials of all kinds – i.e., film,
photography, digital media, and the visual arts, as well as fiction, poetry,
and other literary forms – and projects engaging with non-western litera-
tures and cultures are especially welcome.
 Sandra Dinter • Sarah Schäfer-Althaus
Editors

Medicine and Mobility

in Nineteenth-­
Century British
Literature, History,
and Culture
Editors
Sandra Dinter Sarah Schäfer-Althaus
University of Hamburg University of Koblenz
Hamburg, Germany Koblenz, Germany

ISBN 978-3-031-17019-5    ISBN 978-3-031-17020-1 (eBook)

https://doi.org/10.1007/978-3-031-17020-1

© The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer
Nature Switzerland AG 2023
Chapters ‘Medicine and Mobility in Nineteenth-Century British Literature, History, and
Culture: An Introduction’, ‘Embodied Interdependencies of Health and Travel in Henry
James’s The Portrait of a Lady and Thomas Hardy’s Tess of the d’Urbervilles’, ‘Upright
Posture and Gendered Styles of Body Movements in The Mill on the Floss’, ‘White Fluff/
Black Pigment: Health Commodity Culture and Victorian Imperial Geographies of
Dependence’ and ‘From Heroic Exploration to Careful Control: Mobility, Health, and
Medicine in the British African Empire’ are licensed under the terms of the Creative
Commons Attribution 4.0 International License (http://creativecommons.org/licenses/
by/4.0/). For further details see licence information in the chapters.
This work is subject to copyright. All rights are solely and exclusively licensed by the
Publisher, whether the whole or part of the material is concerned, specifically the rights of
translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on
microfilms or in any other physical way, and transmission or information storage and retrieval,
electronic adaptation, computer software, or by similar or dissimilar methodology now
known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information
in this book are believed to be true and accurate at the date of publication. Neither the pub-
lisher nor the authors or the editors give a warranty, expressed or implied, with respect to the
material contained herein or for any errors or omissions that may have been made. The
publisher remains neutral with regard to jurisdictional claims in published maps and institu-
tional affiliations.

Cover illustration: ParkerDeen/Getty Images

This Palgrave Macmillan imprint is published by the registered company Springer Nature
Switzerland AG.
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
 Acknowledgements

The initial idea for this volume was born amid lively discussions at the
conference “Locating Intersections of Medicine and Mobility in
Nineteenth-Century Britain”, held back in October 2019 in the beautiful
historic library of the Friedrich-Alexander-University of Erlangen-­
Nuremberg (FAU). Little did we know that, for the time being, it would
be our last chance to welcome colleagues from Europe and the USA to
Germany in person, to listen to their presentations, and to enjoy food,
drinks, and even songs together at the conference dinner. This gathering
would have been impossible without the generous funding of the Fritz
Thyssen Foundation, and the Dean’s Office of the School of Humanities,
Social Sciences, and Theology at FAU, for which we are very grateful.
Many thanks go too to Doris Feldmann for her support and interest in the
project from its early stages, and to our former student assistants, Margret
Gareis and Nicolas Löw, for helping us with the preparations for this event.
We are especially obliged to Charlotte Mathieson, who, during one of
the coffee breaks, encouraged us to turn our ideas into a proposal for an
edited collection in the Studies in Mobilities, Literature, and Culture series.
We would like to thank her and her co-series editors Marian Aguiar and
Lynne Pearce for the opportunity to publish our book as part of the series.
Our contributors, whose insights into medicine and mobility in the nine-
teenth century form the heart of this volume, have been brilliant to work
with, and we would like to thank them for their time, commitment, and
patience. Special thanks, moreover, go to Allie Troyanos, Paul Smith
Jesudas, Brian Halm, and Immy Higgins at Palgrave Macmillan for all
their work in producing this book. We would also like to acknowledge the

v
vi ACKNOWLEDGEMENTS

excellent feedback we received from our anonymous reviewer. We are

grateful to our editorial assistant, Marie Kluge, for her invaluable help in
preparing the manuscript.
When we planned our collaboration back in the summer of 2018, we
were blissfully unaware of the extent to which medicine and mobility
would not only keep us preoccupied as the themes of our volume but also
infiltrate our daily lives. First, two uncannily timed medical incidents
immobilised both of us simultaneously for several weeks, turning us into
the protagonists of two twenty-first-century medical case reports in need
of rest cures. If this did not remind us enough of the vulnerability of our
own bodies, the subsequent outbreak of the coronavirus certainly did.
The pandemic showed us more dramatically than ever before that as
mobile matter not only can disease bring even the most globalised world
to a sudden standstill but also that there are undeniable parallels between
the debates on medicine, mobility, and the body of the nineteenth and the
twenty-first centuries.

June 2022 Sandra Dinter

Sarah Schäfer-Althaus
 Contents

1 Medicine
 and Mobility in Nineteenth-­Century British
Literature, History, and Culture: An Introduction  1
Sandra Dinter and Sarah Schäfer-Althaus

Part I Travel and Health  27

2 Doctors’
 Ships: Voyages for Health in the Late
Nineteenth Century 29
Sally Shuttleworth

3 Watering
 Holes: Healthy Waters and Moral Dangers in
the Nineteenth-Century Novel 53
Pamela K. Gilbert

4 Embodied
 Interdependencies of Health and Travel in
Henry James’s The Portrait of a Lady and Thomas Hardy’s
Tess of the d’Urbervilles 75
Natasha Anderson

5 (Mental)
 Health and Travel: Reflections on the Benefits of
Idling in the Victorian Age 97
Heidi Lucja Liedke

vii
viii CONTENTS

Part II Pathologising Mobilities 119

6 Upright
 Posture and Gendered Styles of Body
Movements in The Mill on the Floss121
Monika Class

7 The
 Mobility of Water: Aquatic Transformation and
Disease in Victorian Literature145
Ursula Kluwick

8 A
 “Feverish Restlessness”: Dance as Decadent Mobility in
Late Victorian Poetry165
Stefanie John

9 The
 Wandering Irish: Mobility and Lunacy in Mid-­
Nineteenth-­Century Lancashire187
Catherine Cox and Hilary Marland

Part III Mobilities and Medical Regimens 211

10 Exposure,
 Friction, and “Peculiar Feelings”: Mobile Skin
in Victorian Medicine and Literature213
Ariane de Waal

11 White
 Fluff/Black Pigment: Health Commodity Culture
and Victorian Imperial Geographies of Dependence235
Monika Pietrzak-Franger

12 From
 Heroic Exploration to Careful Control: Mobility,
Health, and Medicine in the British African Empire259
Markku Hokkanen

Index281
 Notes on Contributors

Natasha Anderson is Doctoral Research Fellow at Johannes Gutenberg

University Mainz examining “The Body and the Book: Visceral Reading
Experiences in the Victorian Novel” as part of the project “The Visceral
Novel Reader,” funded by the German Research Foundation. She earned
her MA in American Studies at Johannes Gutenberg University
Mainz and attained her BA in English and History at the University
of Stuttgart. She spent a year abroad at Marymount University in
Virginia and represented Johannes Gutenberg University Mainz in
the Institute for World Literature 2019 at Harvard University. Most
recently, she co-organised two virtual international workshops, pub-
lished an article in the online Journal of European Periodical Studies,
and presented at conferences in Germany, Greece, and Ireland as well as
virtually in Spain, Sweden, the UK, and the USA.
Monika Class is Senior Lecturer in English Studies at Lund University
and Principal Investigator of “The Visceral Novel Reader”, funded by the
German Research Foundation, which is the title of an article (Literature
and Medicine 34.2, 2016) and her second monograph in progress. She
acted as Junior Professor at Johannes Gutenberg University Mainz
and as Postdoctoral Researcher at Konstanz University and King’s
College London’s Centre for Medical Humanities. Her publications
include, as author, Coleridge and Kantian Ideas in England, 1796–1817
(2012); as editor, Nineteenth Century Literature and Philosophy, Vol. 1
(Routledge, forth. 2023), the special issues “Medical Case Histories
as Genre: New Approaches” in Literature and Medicine (2014), and

ix
x NOTES ON CONTRIBUTORS

“Trace: Embodied Approaches to the English Novel” in English

Studies (forth. 2023); and as co-editor, Transnational England: Home
and Abroad, 1780–1860 (2009).
Catherine Cox is Associate Professor at the School of History, University
College Dublin, and was co-Principal Investigator with Hilary Marland on
a Wellcome Trust Investigator Award “Prisoners, Medical Care and
Entitlement to Health in England and Ireland, 1850–2000”. They
have published several joint articles on mental disorder in prisons and
migration and mental health, and their book Disorder Contained:
Mental Breakdown and the Modern Prison in England and Ireland,
1840–1900 was published by Cambridge University Press in 2022.
She has published on psychology and juvenile custodial institutions
in the twentieth century and on the history of psychiatry and medical
practices in nineteenth-century Ireland.
Ariane de Waal is Lecturer at University of Leipzig. Her research focuses
on British literature and culture of the nineteenth and twenty-first centu-
ries. Her book on post-9/11 theatre, Theatre on Terror: Subject Positions
in British Drama, was published by De Gruyter in 2017. She is currently
working on a monograph that investigates the epistemological inter-
sections of dermatology and the Victorian realist novel. She is the
author of the article “Looking Both Ways: Middlemarch, True Skin,
and the Dermatological Gaze” (Victorian Network, 2020) and co-­
editor of the special issue “Victorian Materialisms” (with Ursula Kluwick,
European Journal of English Studies, 2022).
Sandra Dinter is Junior Professor of British Literature and Culture at the
University of Hamburg. After writing her first monograph, Childhood in
the Contemporary English Novel (2019), her research now focuses on
mobility, space, and gender in Victorian literature and culture.
Currently, she is working on another monograph on representations
of women walkers in the nineteenth century. Her work has appeared
in the journals Neo-Victorian Studies, Children’s Literature Association
Quarterly, Anglia, and English Studies.
Pamela K. Gilbert is Albert Brick Professor of English at the University
of Florida. She has published widely in the areas of Victorian literature,
popular culture, the body, and the history of medicine. Her most recent
monograph is Victorian Skin: Surface, Self, History (2019). Other books
include Disease, Desire, and the Body in Victorian Women’s Popular Novels
 NOTES ON CONTRIBUTORS xi

(1997), Mapping the Victorian Social Body (2004), The Citizen’s Body
(2007), and Cholera and Nation (2008). Her collections include
Imagined Londons (2002), Companion to Sensation Fiction (2011), and
the co-edited Blackwell Encyclopedia of Victorian Literature (2015).
Markku Hokkanen is Senior Lecturer in History at the University of
Oulu. His previous publications on medicine and colonialism include the
monograph Medicine, Mobility and the Empire: Nyasaland Networks,
1859–1960 (2017) and the co-edited collection Healers and Empires in
Global History: Healing as Hybrid and Contested Knowledge (with Kalle
Kananoja, Palgrave Macmillan, 2019). He is currently leading an
Academy of Finland-funded research project on histories of healers, poli-
tics, and development in sub-Saharan Africa (2019–2023).
Stefanie John is Lecturer in English Literature and Culture at Technical
University of Braunschweig. Her research interests include poetry from
the Romantic period to the present, literary form and influence, and inter-
sections of literature and material culture. Her first monograph Post-­
Romantic Aesthetics in Contemporary British and Irish Poetry was published
with Routledge in 2021. She is currently working on a project on textile
objects in late Victorian British literature.
Ursula Kluwick is Senior Lecturer in Modern English Literature at the
University of Bern and Senior Researcher in the Project “The Beach in the
Long Twentieth Century” (Swiss National Science Foundation). Among
her main research interests are the Victorian period; the Environmental,
especially the Blue, Humanities, postcolonial literatures; and non-­
realist forms of writing. Her books include the monograph Exploring
Magic Realism in Salman Rushdie’s Fiction (2011) and the co-edited
collection The Beach in Anglophone Literatures and Cultures (with
Virginia Richter, 2015). She has co-edited the special issue “Victorian
Materialisms” (with Ariane de Waal, European Journal of English
Studies, 2022) and is currently preparing her monograph on Victorian
water writing for publication.
Heidi Lucja Liedke is Senior Lecturer in English Literature at the
University of Kaiserslautern-Landau (RPTU). She was awarded her venia
legendi for British literary and cultural studies in 2021. From 2018 to
2020, she was Humboldt Foundation Postdoctoral Fellow at Queen Mary
University of London. Her research interests include Victorian travel
writing and idling, contemporary British performance and live
xii NOTES ON CONTRIBUTORS

t­heatre broadcasting, and new forms of criticism. Recent publications

with a focus on Victorian topics include a monograph on the cultural
history of sloths (with Tobias Keiling, Faultiere. Ein Portrait, Matthes
& Seitz, 2021) and a chapter on Victorian panoramas in Victorian
Surfaces in Nineteenth-Century Literature and Culture (edited by Sibylle
Baumbach and Ulla Ratheiser, Palgrave Macmillan, 2021).
Hilary Marland is based at the Centre for the History of Medicine,
University of Warwick. She was co-Principal Investigator with Catherine
Cox on a Wellcome Trust Investigator Award “Prisoners, Medical Care
and Entitlement to Health in England and Ireland, 1850–2000” and cur-
rently leads a Wellcome Trust-funded project on postnatal mental
illness in twentieth-century Britain. Together with Catherine Cox,
she has published several articles on mental disorder in prisons and
migration and mental health, and their book Disorder Contained:
Mental Breakdown and the Modern Prison in England and Ireland,
1840–1900 appeared with Cambridge University Press in 2022. Her
other research interests include the history of childbirth, girl’s health, and
household medicine in the nineteenth century.
Monika Pietrzak-Franger is Professor of British Cultural and Literary
Studies at the University of Vienna. Her areas of research range from
adaptation and transmediality to (neo-)Victorian studies and Medical
Humanities. Her publications include, as author, Syphilis in Victorian
Literature and Culture: Medicine, Knowledge and the Spectacle of Victorian
Invisibility (Palgrave Macmillan, 2017); as editor, Women, Beauty, and
Fashion (2014); and as co-editor, Reflecting on Darwin (2014), Handbook
of the English Novel, 1830–1900 (2020), Transmedia Practices in the Long
Nineteenth Century (2022), and Literature and Medicine (Cambridge
University Press, forth. 2023), as well as of special issues on “Disease,
Communication, and the Ethics of (In)visibility” (2014), “Neo-­
Victorianism and Globalisation” (2015), and “Transforming Medical
Humanities” (forth. 2023). Currently, she is co-leading the interuni-
versity cluster “Post-COVID-19 Care” and working on visiodemics and
viral theatre.
Sarah Schäfer-Althaus is Lecturer in Anglophone Literature and Culture
at the University of Koblenz. Her research centres on women, gender, and
sexuality studies with a focus on body theory, medical humanities, and the
history of childbirth. She is author of The Gendered Body: Female Sanctity,
 NOTES ON CONTRIBUTORS xiii

Gender Hybridity and the Body in Women’s Hagiography (2017) and co-­
editor of Transient Bodies in Anglophone Literature and Culture (2020),
both published with Universitätsverlag Winter, and Traveling Bodies
(Routledge, forth. 2023).
Sally Shuttleworth is Senior Research Fellow at the University of
Oxford. She has published extensively on the interrelations of medicine,
science, and culture and, between 2014 and 2019, ran the large ERC
research project “Diseases of Modern Life: Nineteenth-Century
Perspectives” (https://diseasesofmodernlife.web.ox.ac.uk/). Her most
recent books are the co-authored Anxious Times: Medicine and Modernity
in Nineteenth-Century Britain (2019) and the co-edited volume Science
Periodicals in Nineteenth-Century Britain: Constructing Scientific
Communities (2020).
 List of Figures

Fig. 2.1 “Sobraon”. From the album of a passenger on the 1884 voyage
from London to Melbourne. Courtesy of the University of
Waikato Library 30
Fig. 2.2 “Our Voyage”. Title page of Sobraon Gossip (1875). Courtesy
of the National Library of Australia, nla.obj-441576471 40
Fig. 2.3 “Dear little ‘Bonnie’. ‘Sobraon.’” From the album of a
passenger on the 1884 voyage from London to Melbourne.
Courtesy of the University of Waikato Library 42
Fig. 2.4 Harold John Graham, “On the Sobraon”, October 1881.
Courtesy of the National Library of Australia, nla.obj-139421279 44

xv
 CHAPTER 1

Medicine and Mobility

in Nineteenth-­Century British Literature,
History, and Culture: An Introduction

Sandra Dinter and Sarah Schäfer-Althaus

On a bustling Monday morning, Mary Barton, the heroine of Elizabeth

Gaskell’s eponymous 1848 novel, leaves her home in Manchester to set
out for Liverpool, hoping to find the sailor Will Wilson to testify in favour
of her lover, Jem Wilson. Accused of murder, Jem is awaiting his court
trial, which is to take place the following day. Will’s alibi is his only hope
of escaping the death penalty. In her quest, Mary makes use of various
modes of transport. First, she boards a train. The narrator notes that
“[c]ommon as railroads are now in places as a means of transit, and espe-
cially in Manchester, Mary had never been on one before; and she felt

S. Dinter (*)
University of Hamburg, Hamburg, Germany
e-mail: sandra.dinter@uni-hamburg.de
S. Schäfer-Althaus
University of Koblenz, Koblenz, Germany
e-mail: salthaus@uni-koblenz.de

© The Author(s) 2023 1

S. Dinter, S. Schäfer-Althaus (eds.), Medicine and Mobility in
Nineteenth-Century British Literature, History, and Culture,
Studies in Mobilities, Literature, and Culture,
https://doi.org/10.1007/978-3-031-17020-1_1
2 S. DINTER AND S. SCHÄFER-ALTHAUS

bewildered by the hurry, the noise of people, and bells, and horns; the
whiz and the scream of the arriving trains” (Gaskell 2006, 273), evoking
an overwhelming visceral experience of modernity. In Liverpool, Mary
moves in more familiar ways, making her way through the streets on foot,
but this causes her even more distress. She briefly “stop[s] to regain her
breath, and to gather strength, for her limbs trembled, and her heart beat
violently” (275) and then feels how her chest “tightened, and her head
[was] throbbing, from the rate at which they were walking” (279). Shortly
thereafter, Mary hires a small boat to chase after Will on the John Cropper.
To Mary, who has never been on a boat before, the harbour, with its
“puffs and clouds of smoke from the countless steamers”, constitutes
another “new world of sight and sound” (281). The further she advances,
the more her constitution deteriorates. Mary feels “despair […] creeping
over her”, and “every minute her mind became more cloudy” (289), until
she is “sitting motionless” (290) on the boat. Taken in by one of the sail-
ors once back on shore, Mary collapses on the floor. In a distinctly
Victorian fashion, the boatman and his wife attempt to nurse her back to
health: they burn feathers, give her “Golden Wasser”,1 and place her in a
chair (302). Mary briefly regains her strength when she testifies in court
but then falls ill with a fever. Her accelerated journey ends with weeks of
stasis in a sickroom.
As this episode suggests, medicine and mobility are significant and
meaningful concepts in Mary Barton. Referring to Gaskell’s depictions of
illness, substance abuse, medical treatments, and death, Meegan Kennedy,
for instance, notes that “Mary Barton provides a good example of how
ailments can pile up in a Victorian novel” (2013, 464). Highlighting char-
acters’ movements in and beyond Manchester, Alan Shelston, in turn, pro-
poses that it “is a novel full of journeys” (2006, 95). While these are two
pertinent approaches to Gaskell’s novel, they have not informed each
other. Mary Barton has mostly been read as a work that is either con-
cerned with medicine or with mobility, which is remarkable given how
evidently Mary’s motions and health are linked.
Medicine and Mobility in Nineteenth-Century British Literature,
History, and Culture, in contrast, proposes that new insights can be gained
by analysing the cultural and literary histories of medicine and mobility as
entangled processes whose discourses and practices constituted, influ-
enced, and transformed each other. With this bidirectional perspective,
this collection of essays makes a methodological and interdisciplinary
intervention. It initiates a dialogue between mobility studies and the
 1 MEDICINE AND MOBILITY IN NINETEENTH-CENTURY BRITISH… 3

medical humanities, two emerging fields that have rarely been discussed in
relation to one another. Presenting case studies of novels, poetry, travel
narratives, diaries, ship magazines, skin care manuals, asylum records,
press reports, and various other sources, the contributions in this volume
identify and discuss diverse literary, historical, and cultural texts, contexts,
and modes in which medicine and mobility intersected in nineteenth-­
century Britain, its empire, and beyond, whereby they illustrate how the
paradigms of mobility studies and the medical humanities can comple-
ment each other. Setting the scene, this introduction charts the major
historical and cultural transformations of medicine and mobility and their
entanglements in nineteenth-century Britain and surveys current positions
and crossovers in mobility studies and the medical humanities.

Historical Coordinates: Medicine, Mobility,

and Their Entanglements
in Nineteenth-Century Britain

Britain witnessed a pervasive professionalisation, institutionalisation, and

commercialisation of medical practice and research in the nineteenth cen-
tury. Surveying the period’s impressive scope and range of medical innova-
tions, Lawrence Rothfield notes that “[i]n the course of Victoria’s lifetime
(1819–1901), smallpox vaccination was made compulsory; the postmor-
tem autopsy became routine; anatomy and pathology were established as
standard elements of a medical school education; inhalation anaesthesia
was introduced; physicians discovered that at least some diseases were
transmitted not by atmosphere-corrupting poison seeping from decom-
posing organic matter but by germs; antiseptic surgery began to be prac-
ticed; preventive and occupational medicine as well as public health and
sanitary medicine were founded. The general practitioner appeared, along
with the professional nurse and a range of specialists in fields such as psy-
chiatry, neurology, sexology, and obstetrics” (2014, 175).2 With the
expansion of the British Empire, medicine extended its territorial bound-
aries, leading to the formation of the International Red Cross in 1864 and
the establishment of tropical medicine as a new branch of medicine (Porter
2011b, 163). As medical knowledge and practice became more sophisti-
cated, and technological developments such as the stethoscope (1816)
and the discovery of X-rays (1895) enhanced medical examination
4 S. DINTER AND S. SCHÄFER-ALTHAUS

methods, medical care became more accessible to all social classes, mark-
ing the nineteenth century as an “age of improvement” (Porter 1999, 348).
Despite these advancements, it would be inaccurate to give an exclu-
sively progressivist account of the period’s health and medical practices.
Poor sanitation remained a major concern, particularly in the crowded
streets of the growing metropolises, significantly increasing the spread of
infectious diseases (Allen 2008, 1–23). Between the 1830s and 1860s, the
cholera epidemics, for instance, “generated terror and panic” among the
population due to a lack of effective remedies and its “frighteningly rapid
course: victims could be well in the morning and dead by nightfall”
(Brunton 2019, 16; see also Gilbert 2009; Wilson Carpenter 2010,
34–53). New scientific concepts did not gain authority immediately but
emerged “alongside other and older systems of medicine” (Brunton 2019,
3). The older miasma model of disease, for example, remained influential
despite the growing authority of germ theory. Understandings of disease
transmission linked to heredity, (immoral) behaviours, and environmental
factors were equally enduring, as William Buchan’s popular health guide
Domestic Medicine (1848 [1769]) demonstrates; Buchan lists exposure to
“unwholesome air” (152), “frequent and excessive debaucheries”, and
“violent passions” (153) as possible causes for tuberculosis (phthisis).3 As
effective medicines were rare, traditional therapies persisted, and doctors
continued to advise bloodletting, moderate exercise, “taking the waters”,
or a “change of air” for various diseases and ailments, including tubercu-
losis and other pulmonary and respiratory illnesses, as well as nervous dis-
orders and sedentary behaviours (Buchan 1848; see also Porter 1999, 674).
The institutionalisation of medical practice began in the mid-nineteenth
century. Doctors, nurses, and other health officials were now licensed and
publicly registered, and patients were documented and classified.4 This
bureaucratisation forged new power structures, sometimes with severe
consequences for individuals, including “women, the poor, those with dis-
tinctive sexual habits or emotional makeups or cognitive capacities – whose
difference could be defined as pathology in need of monitoring, therapy,
regulation: in need, in short, of discipline” (Rothfield 2014, 176). Diseases
were often moralised, stigmatising groups and individuals, which led to
the strict isolation and control of “patients” in hospitals, sanatoriums,
mental asylums, and their homes.5 The cholera outbreaks were, for exam-
ple, “blamed […] on the low morals and drunkenness of the poor”; other
ailments were considered exclusively female (Porter 2011a, 90). As the
representation of Mary Barton’s frailty, anxieties, and melodramatic
 1 MEDICINE AND MOBILITY IN NINETEENTH-CENTURY BRITISH… 5

breakdown indicates, being a woman was considered “inherently patho-

logical”, resulting in many “sexual atrocities committed on female patients
in the name of medicine” (90), among them ovariotomy and even clitori-
dectomy to cure alleged “female conditions” like hysteria and nymphoma-
nia (Laqueur 1992, 176; see also Porter 1999, 364). This medicalisation
installed an authoritative system of “medico-moral policing” and “medical
surveillance” of the social body (Rothfield 2014, 178).
With the rise of consumerism and market society, the self-monitoring
of British citizens’ physical and mental constitutions became a matter of
civic responsibility. Along with new systems of knowledge production and
dissemination, the severe contagions of the period made people aware of
the numerous health hazards that could affect their bodies (Haley 1978,
5–6). It is no surprise then that “[n]o topic more occupied the Victorian
mind than Health” (3). Good health was promoted as achievable for, and
thus controllable by, the individual through sensible behaviour and con-
sumerism, and people began to invest more time and money in their health
and well-being. As Bruce Haley resumes, “[i]n the name of Health,
Victorians flocked to the seaside, tramped about in the Alps or Cotswolds,
dieted, took pills, sweated themselves in Turkish baths, adopted this ‘sys-
tem’ of medicine or that” (3). By the end of the century, “health became
something that could be built up by pursuing a range of activities, to reach
a state of vigour and overflowing vitality” (Brunton 2019, 47). When
holistic health emerged as a new ideal, if not norm, medical regimens—
including homoeopathy, gymnastics, and skincare routines—enjoyed
unprecedented popularity, as several contributions in this volume confirm.
As well as playing host to these transformations in medicine, the nine-
teenth century in Britain is also remembered as the age of the transport
revolution, generating a range of new mobile practices. The perfection of
the steam engine, for example, initiated the shift from a maritime industry
of sailing ships to that of steamships. “For the first time [in British his-
tory]”, David M. Williams and John Armstrong assert, “vessels were not
at the mercy of wind or tide and this, together with the ability to make or
leave port at will, permitted scheduled services” (2012, 43). Itself a prod-
uct of capitalism and industrialisation, steamship technology in turn facili-
tated these systems by making global trade and transport more efficient
and profitable. On land, steam engine technology initiated “huge historic
shifts away from travelling by feet (and indeed by horse), to travelling by
train, bus and coach” (Urry 2007, 90). From the opening of the first rail-
way connection between Liverpool and Manchester in 1830—the same
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