Romantic Medicine and the Poetics of Palliation by Brittany Pladek A thesis submitted in conformity with the requirements for the degree of Doctor of Philosophy Department of English University of Toronto © Copyright by Brittany Pladek (2013) Romantic Medicine and the Poetics of Palliation Brittany Pladek Doctor of Philosophy Department of English University of Toronto 2013 Abstract This study uses the interdisciplinary lens of Romantic medical ethics to reconsider received ideas about the therapeutic power of Romantic poetry. Studies of literature and medicine in the long nineteenth century have generally considered disease the era’s main medical symbol; they have likewise considered holistic “healing” its major model for poetry’s therapeutic effect, following Geoffrey Hartman’s description of Wordsworth’s ability to “heal the wound of self.” Without denying the importance of these paradigms, my work explores alternate foci: pain instead of disease, and palliation instead of healing. In Britain, professional medical ethics were first codified during the Romantic period in response to a variety of medical and social advances. But because of Romantic medicine’s curative uncertainty and utilitarian intolerance for pain, its ethicists turned from cure to palliation to describe a doctor’s primary duty toward his patients. My study argues that this palliative ethic was taken up by Romantic literary writers to describe their own work. By engaging with contemporary medical ethics treatises such as John Gregory’s 1770 Lectures on the Duties and Qualifications of a Physician and Thomas Percival’s 1803 Medical Ethics, I explore four Romantic authors’ struggle to find an appropriate medical model for their work’s therapeutic benefits. Ultimately, all turned their attention from “healing the wound of self” to palliating the agonies of a world where, as Wordsworth writes, “suffering is ii permanent, obscure and dark.” Reading William Wordsworth, Mary Shelley, John Keats, and Thomas Lovell Beddoes through a palliative lens reveals a diversity of perspectives on the therapeutic potential of literary writing and challenges our received picture of their engagement with medical ideas: e.g. Wordsworth, hailed by Matthew Arnold for his “healing power,” found an alternate model for his poetry’s medical benefits, while Keats finally abandoned his early belief that the poet should be “physician to all men.” My study follows these four writers as they variously embrace, qualify, or outright reject the idea that literature could, as Keats had once hoped, “sooth the cares and lift the thoughts of man.” iii Acknowledgments This research was supported by a scholarship from the Connaught Fund at the University of Toronto; a Doctoral Fellowship from the University of Toronto; and a Thesis Completion Grant from the Department of English at the University of Toronto. I am thankful to the helpful and patient librarians of the Wellcome Institute in London, where I conducted primary research for this project in the summer of 2011. Parts of Chapters 1 and 2 first appeared in European Romantic Review 23.3 (2012): 403-13 under the title, “‘Soothing Thoughts’: Romantic Palliative Care and the Poetics of Relief.” Copyright © 2012 Taylor and Francis Group. I would like to begin by thanking Karen Weisman and Heather Jackson, who guided me during the early stages of this project and during my decision to change fields from medieval to Romantic literature. I am also grateful for the guidance of Mary Fissell, who generously helped me through preparing my first publication and introduced me to a vibrant community of historians of medicine. Throughout the process of writing this dissertation, I have been aided by the generous and thoughtful suggestions of Deidre Lynch and Cannon Schmitt. Their intellectual excitement has inspired me, and their incisive editorial advice has been invaluable. I am especially grateful to Alan Bewell, whose encouragement has helped me through the rough spots of this project and whose intellectual mentorship has been consistently stimulating and challenging. As a supervisor, his uncanny ability to know what needs to be done has helped me mature as a writer, thinker, and junior scholar. Finally, I would never have completed this project at all if it had not been for the incredible support of family and friends, especially the dynamic graduate community at the University of Toronto. Thanks especially to Joel Rodgers, with whom I spent many nights talking through my ideas, and the members of my writing group. And finally, thank you to Jonathan Abresch for his amazing patience and support, writing suggestions, and careful editing eye. iv Table of Contents Acknowledgments.......................................................................................................................... iv Table of Contents............................................................................................................................ v Introduction..................................................................................................................................... 1 1 “Soothing thoughts”: William Wordsworth and the Poetry of Relief.................................... 19 2 Palliating Humanity in The Last Man..................................................................................... 58 3 John Keats’s “Sickness Not Ignoble”..................................................................................... 99 4 The Euthanasia of Thomas Lovell Beddoes......................................................................... 145 5 Coda. Literature, Medicine, and the Palliative Subject ........................................................ 183 Works Consulted......................................................................................................................... 198 v 1 Introduction Step into the courtyard of Guy’s Hospital sometime in 1805. Around you rise walls of dark brick filled with windows to let in light and air. Quiet talk and moans drift down from the wards above, where rows of bed-bound patients await the daily visit of their attending physician or surgeon. Medical students, harried as today, dart across the courtyard to lectures in nearby surgical theatres. Across the street, cured patients walk gratefully away from the hospital, ruminating on their physician’s advice on how to live healthier lives. Those less lucky head towards the local apothecary’s shop, where they will purchase medications to manage a chronic condition. And some patients do not leave at all. Guy’s was originally founded as an incurables hospital, and a large number of terminal cases still pass through its doors. Its doctors are therefore trained to treat patients at all stages of illness, from the light cough of a genteel hypochondriac—who would almost certainly be attended at home, anyway—to the fatal, festering bullet sore of a soldier wounded at the recent Battle of Trafalgar. As a snapshot of Romantic medicine, you could do worse than Guy’s. The large London hospital, like its sister institutions St. Thomas’s, Bartholomew’s, Bethlem, and the London Hospital, operated at the metropolitan hub of a medical landscape undergoing rapid and profound changes. The final stretch of the Georgian era was a time of feverish advance and frustrating setback for British medicine. Anatomical knowledge increased as surgeons like John Hunter and Charles Bell probed the human body and recorded their findings. Chemistry advanced, tugging medicine along with it: oxygen and nitrous oxide (laughing gas) were discovered in the same decade by the same man, Joseph Priestley. And preventative medicine became a greater public concern, with figures like Thomas Beddoes promoting healthy living and Edward Jenner administering the first smallpox vaccine. Yet for all these medical successes, the roots of illness remained undiscovered. The “vital principle” sought throughout the eighteenth and early nineteenth centuries was not located, the debate over the material or spiritual location of life left unresolved. Dreams of human immortality voiced by eighteenth-century theorists like William Godwin proved medically unsupportable, as the did milder hopes of 2 scientific philosophers like Pierre Jean George Cabanis that sickness could be eliminated and old age made universal.1 Disease still ripped through cities, like the yellow fever epidemic of 1793 that killed over 5,000 people in Philadelphia. And while the Napoleonic wars spurred advances in battlefield medicine, thousands still died directly of wounds, or, more often, indirectly of illnesses like typhus and gangrene. Working at one of the biggest hospitals in England, Guy’s doctors would have been daily exposed to the complex range of triumphs and disappointments that characterized their medical milieu. Further, they faced this complexity as members of an increasingly recognizable professional class. At the turn of the nineteenth century, British medicine was professionalizing. The 1815 Apothecaries Act introduced competency requirements for general practitioners, then known as apothecaries; later acts would finally dissolve the nebulous distinctions between physicians, surgeons, and apothecaries. Medical ethics and professional behavior treatises proliferated, most famously John Gregory’s 1770 Lectures on the Duties and Qualifications of a Physician and Thomas Percival’s 1803 Medical Ethics. In addition to their daily battles with disease, Britain’s doctors were being challenged to redefine their role