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The Sickroom in Victorian Literature

A regular column that examines the history and origins of a particular medical topic.

There is hardly a Victorian novel without at least one sickroom scene, and most have several; Elizabeth Gaskell's novel Ruth weighs in with 12. As lives slipped away in these fetid bedrooms, family secrets were revealed and people's characters become more finely etched.

Usually the attendant medical fraternity is portrayed as grave and marginal, offering a supporting role rather than initiating heroic intervention. The patient enjoyed the spotlight and often previously sought attention. Jemima in Ruth wistfully remarks, ‘I almost wish I were ill that I might make you care for me'.

Tuberculosis was rampant in the mid-19th century. A wasting disease, the picture of ethereally pale and gaunt young women gasping their last was a common feature not only of Victorian literature but opera as well - see the tubercular and dying Mimi in Puccini's La Bohème who sings with remarkable gusto for someone in the last throws of a debilitating malady.

The ‘vapours' were a good diagnosis for young ladies who took to their beds feeling pale, fragile and interesting. Lady Mary Wortley Montague wrote the poem A Receipt to Cure the Vapours, which could have been a medical homily for the Victorian hypochondriac. It starts:

Why will Delia thus retire
And why languish life away?
While the sighing crowd admire.

It seems boyfriend Damon had died and ‘Long ago the worms have ate him', as the author rather heartlessly puts it, but Delia had accomplished the first objective of her mission by attracting a ‘sighing crowd'.

It was not only sufferers from the vapours who drew comfort from sickroom ambience; those who were really ill seemed to enjoy the experience. There is ample testimony to the therapeutic effect of ‘life in the sickroom'. Indeed, Harriot Matineau, an invalid from 1839 to 1844, then cured by mesmerism, as hypnotism was then called, wrote a popular book of that title. After five years' experience, who better qualified?

After a long illness, in 1843 novelist Maria Edgeworth wrote to a friend ‘...my illness was a source of more pleasure than pain to me and I would willingly go through all the fever... to have the delight of the feeling of warm affection from others and consequent unspeakable sensation of gratitude'. She clearly enjoyed ill health.

The sickrooms which appear in the novels of Charles Dickens surpassed even the tearjerkers of his contemporary scribes, and generally seem to serve as a kind of release into heaven; Oliver Twist and Tiny Tim are prime examples. But Dickens also describes the sickroom from the other side of the bed, so to speak, in his sublime portrayal of the indefatigable Sairey Gamp, nurse extraordinaire who made her appearance in 1844 in Martin Chuzzlewit. Her story is a masterpiece of humour and fraught mid-19th century bedroom scenes.

Until the advent of the Nightingale era of the 1850s, nurses had been regarded as a disreputable lot: dirty, drinkers by choice and avaricious by nature. No selfrespecting female would undertake the job; it was one for the so-called lower social orders. Dickens revelled in tales of this level of Victorian society and got all the crude excesses of the pre-Nightingale era into the character of the glorious Sairey Gamp.

So popular was his portrayal that Mrs Gamp, though fictitious, became the most famous midwife of the times. Due to her habit when on her rounds of always carrying a bulky umbrella, her surname has passed into the English language: ‘a gamp - an umbrella, especially a large untidy one'. She is also remembered for her immortal line regarding a patient: ‘He'd make a lovely corpse'.

The writer had the lady's less than salubrious lodging in a bird fancier's house and opposite a cat meat warehouse. Her first floor rooms were rented for being ‘easily assailable at night by pebbles, walking sticks and fragments of tobacco-pipe' which was flung up in order to attract her alcohol-befuddled attention.

A fat woman with a husky voice, she possessed rheumy eyes which could be turned up so only the white showed. She had a fragile relationship with sobriety. As Dickens writes, ‘it was difficult to enjoy her company without becoming conscious of a smell of spirits'.

Though a self-styled midwife, if asked and payment assured, she was not above attending ‘childbeds, feverbeds and deathbeds'. She would go to a labouring mother's lying-in or a deceased person's laying-out with ‘equal zest and relish'. The only time she had felt faint was when she saw her late husband on the slab at Guy's Hospital, ‘with a penny piece on each eye and his wooden leg under his left arm'.

Sairey Gamp endeavoured to justify her drinking habit by claiming to follow the advice of her fictitious friend, Mrs Harris. She would recount the bogus conversation between the two in which it was concluded that the resolve of the nurse would be strengthened if a bottle was left on the chimney piece ‘just so I can put it to my lips, nothing more'.

Although Dickens portrayed her wonderfully as the archetypal early Victorian local handy midwife, she herself saw an easier living was to be made in laying out the dead. For this chore she charged ‘eighteen pence for working people and three and six for gentlefolk', but conspiratorially hinted that she would do it for nothing as long as the bottle was left, ‘and let me put my lips to it when I am so disposed'.

In Martin Chuzzlewit, Mr Pecksniff brings Mrs Gamp to Mr Mould, the undertaker. The situation allows Dickens to give the classic description of any funeral director, of any age, when he writes, ‘[he was a man] with a face in which a queer attempt at melancholy was at odds with a smirk of satisfaction; so that he looked as a man might, who, in the very act of smacking his lips over choice old wine, tried to make believe it was physic'.

The Victorian sickroom, with its hushed voices, plumped pillows, gathered family and a pervading air of inevitability, was the delight of many novelists. The scenario was milked for all it was worth to satisfy a part scandalised and part fascinated audience. But the tableau eventually changed for two reasons.

First, the discovery in the 1860s that the common infections of cholera and typhoid were not caused by ‘bad air' (the miasma theory) but from contaminated water. So with proper sewage disposal and keeping water and waste well apart, health improved.

And second, in the 1880s and 1890s it was discovered that infectious diseases (for example, TB) were actually caused by micro-organisms. Appropriate treatment followed and many of the sickroom pathologies were cured, thus consigning Victorian authors' rich and lucrative seam of sickroom dramas to become a thing of the past.

Australian Cosmetic Surgery Magazine