The Idealization of Consumption:Perpetuating Female Gender Roles
Cindy Fan
WGST 239: Art, Medicine, and GenderProfessor Hammerschlag
March 25, 2017
Introducing Tuberculosis: Etymology and History
Each year more than nine million new cases of tuberculosis are reported,
with the disease causing an estimated 1.7 million mortalities across the
globe.1 With improved technologies and medicines this number has been
steadily declining since the 1980s, yet tuberculosis remains one of the
biggest killers worldwide. It is therefore surprising that the disease was
historically romanticized, even desired. During the Romantic period of the
late eighteenth and early nineteenth centuries, tuberculosis was
sentimentalized as the illness of gifted intellectuals. At its height during
Victorian England, tuberculosis killed more people than cholera and
smallpox combined.2 Popularly known as “consumption” before the term
“tuberculosis” was coined in 1839, the disease appeared to “consume” its
victims as they experienced dramatic weight loss. By the end of the
nineteenth century, a consumptive aesthetic had developed, and the disease
became associated with beautiful upper-class women. In this paper, I
examine the history of tuberculosis, its romanticism, and the creation of the
consumptive aesthetic by referencing specific visual and literary works that
depict or describe consumption. Women, I will argue, strived to emulate
consumptives both symbolically and aesthetically, in an effort to conform to
detrimental gender norms and expectations.
1 Stephen D. Lawn, et al., "Tuberculosis," The Lancet 378, no. 9785 (2011): 57.22 Katherine Byrne, Tuberculosis and the Victorian Literary Imagination (Cambridge: Cambridge University Press 2011), 1.
2
Long before the terms ‘consumption’ and ‘tuberculosis’ were
popularly used, the ancient Greeks coined the term ‘phthisis’ to describe
the disease, a term literally translated as ‘wasting.’3 In medical contexts
phthisis continued to be used until the modern medical term ‘pulmonary
tuberculosis’ was employed. During the eighteenth and nineteenth
centuries, tuberculosis was popularly known as ‘consumption,’ referring to
the rapid weight loss that ate away at its victims. In 1839, Johann Lukas
Schönlein referred to the disease by its modern name ‘tuberculosis,’
referring to the formation of tubercles that accompanies the onset of the
disease. However, this term was relatively unused until the German
bacteriologist Robert Koch brought attention to the infectious nature of the
disease, rendering tuberculosis visible to the human eye using new
laboratory techniques. He even introduced the abbreviation of tubercle
bacillus: TB.4
Tuberculosis is caused by the mycobacterium tuberculosis complex
(MBTC), which is the bacteria responsible for TB in humans.5 Due to their
thick cell walls, mycobacteria easily resist “long exposure to acids and
alkalis,…splitting or lysis by proteins in body fluids, and…antibiotics like
penicillin, which do battle by destroying the cell coat of many other common
disease-causing bacteria.”9 Furthermore, the complexity of the bacterium’s
33 Thomas Dormandy, The White Death: A History of Tuberculosis (New York: New York University Press 2000), 2.
44 Helen Bynum, Spitting Blood (Oxford: Oxford University Press), 96.5 5 Ibid., 3.9 Ibid., 4.
3
cell wall results in slow divisionabout once every twenty to twenty-four
hourscontributing to the chronic nature of the disease.7 Tuberculosis
primarily infects the lungs, and is transmitted via air through coughing and
sneezing. While 90 percent of affected patients are asymptomatic, the ten
percent who are symptomatic can experience fever, chills, night sweats,
appetite loss, weight loss, fatigue, or even cough up blood.8
Consumption and the Romantic Period
During the early decades of the nineteenth century, consumption was
responsible for one-fifth of all deaths in England. The Industrial Revolution
ushered in an era of rapid economic development. This growth was
accompanied by a rise in the number of factories where workers endured
appalling working conditions that aided the rapid spread of the disease.
Before the Factory Acts “limited the hours worked, improved the conditions
within the factory buildings, and made inspections mandatory,”9 workers
were “concentrated…together in machine rooms for shifts lasting…twelve
hours.”10 The “hot and humid air, filled with tiny, irritating [fibers],
facilitated the…spread of bacteria.”11 With transmission advanced by
overcrowding, low wages, and poor working conditions, consumption
became a disease of the working poor.
77 Ibid.88 Ibid.99 Bynum, Spitting Blood, 112.10 Ibid., 111.11 Ibid., 112.
4
Around 1830, the number of consumptive deaths began to fall for the
first time since the Industrial Revolution, decreasing slowly but steadily
throughout the rest of the century. Despite this decline, it was still “the
biggest single killer of men and women in their physical and productive
prime,”12 killing “more than a third of those aged 15 to 34 and half of the 20
to 24 age group.”13 Four million or 13 percent of all deaths between 1851
and 1910 were consumptive.14 Although a higher proportion of women died
from consumption during the mid-nineteenth century, the majority of people
who contracted the disease were working-class men, with potentially
devastating financial implications for their families.15 Given the devastating
effect of consumption on the working classes, the romanticism of
consumption was mostly limited to the upper classes, whose higher incomes
could afford medical treatment and necessitated less exposure to
overcrowded environments like factories in which the disease spread
quickly. Higher rates of literacy and exposure to artistic and literary works
resulted in the rapid spread of consumptive ideals among the upper
echelons of society. Indeed, the high human toll of the disease among the
lower classes in English society caused the Lancet in 1882 to label the
consumption’s idealization “as false as can well be.”16
12 Byrne, Tuberculosis and the Victorian Literary Imagination, 12.13 Bynum, Spitting Blood, 110.14 Ibid.15 Ibid.16 Lancet, 30 Sept. 1882
5
This romanticization of consumption—and especially death by
consumption—manifested itself in art, literature, and culture of the time.
During the Romantic Era from the end of the eighteenth century to its peak
in the first half of the nineteenth century, artists, intellectuals, and literary
figures played a defining role in consumptive romanticism. Because
romantics revered the “liberation of the mind and spirit…[from] the
corporeal shackle that was the human body,”17 true artists were those with
strong minds manifested in weak, ill bodies, to the extent that physical
health was considered “earthly, prosaic, even vulgar.”18 Additionally,
numerous well-known Romantic period artists and writers suffered from
consumption. These prominent and supposedly gifted figures interacted
with consumption through direct suffering or artistic representation,
causing the disease to become identified “with youth, genius and tragedy.”19
John Keats (1795-1821), an English Romantic poet, wrote “Ode to a
Nightingale” in 1819 as he began experiencing the initial symptoms of
consumption. The poem became one of Keats’s most famous works,
catapulting the nature of Keats’s illness into the public spotlight. The poem
describes Keats’s personal journey into a state of negative capacity,
referencing an immortal nightingale that experiences death but does not
actually die. Drawing symbolic parallels to the disease in its thematic
exploration of mortality, impermanence, and ecstasy, the poem seeks
17 Byrne, Tuberculosis and the Victorian Literary Imagination, 94. 18 Ibid.19 Ibid.
6
“beauty in [the] ‘horror’ and ‘melancholy’ of consumption.”20 In the third
stanza, Keats alludes to the wasting away of consumptive patients through
fading away:
Fade far away, dissolve, and quite forgetWhat thou among the leaves hast never known,The weariness, the fever, and the fretHere, where men sit and hear each other groan;Where palsy shakes a few, sad, last gray hairs,Where youth grows pale, and spectre-thin, and dies;Where but to think is to be full of sorrowAnd leaden-eyed despairs,Where Beauty cannot keep her lustrous eyes,Or new Love pine at them beyond to-morrow.21
Another famed consumptive of the Romantic period was the Polish
composer and Romantic era pianist Frédéric Chopin (1810-1849). Suffering
from some sort of “cold in the chest” that began when he was sixteen,
Chopin had always been perceived as delicate.22 These health concerns
went largely unaddressed, especially as his success at the piano continued
to grow. Chopin’s musical inspiration seemed endless; he was admired for
both his ability to play and compose; he was cherished “by a dazzling circle
of artists and musicians including Liszt, Berlioz, Mendelssohn,…the famous
cellist Franchomme, and the piano-maker Camille Pleyel.”23 In fact, his
frailness further enhanced his public image as the epitome of the Romantic
artist, inextricably linked with the idealized consumptive who was “pale,
almost transparent, but alight with the flame of creative genius.”24 20 Ibid.21 John Keats, John Keats: The Major Works: Including Endymion, the Odes and Selected Letters (Oxford World's Classics) (Oxford: Oxford University Press, 2009), 285.22 Dormandy, The White Death, 106.23 Ibid., 107. 24 Ibid.
7
French painter Félix-Joseph Barrias’s painting The Death of Chopin
(1885) depicts Chopin on his deathbed (Fig. 1). His white garb emphasizes
his deathly pallor, presenting him as the idealized Romantic era artist
plagued by consumption. Chopin is serenaded by the famed Swedish
soprano opera singer Johanna Maria Lind. Like Chopin, she was an
extremely successful musical figure with international admirers. Though
Lind never contracted tuberculosis herself, her appearance parallels that of
Chopin’s glorified deathbed scene through her white robes, pale skin, and
delicate frame.
While Lind’s presence in Barrias’s painting alludes to the popular
association of consumption with women, the consumptive is undoubtedly
male. This painting connects an early consumptive aesthetic to so-called
creative geniuses who were believed to be weak in body but strong in mind,
before images of young beautiful consumptive women become
commonplace.
The Victorian Consumptive Aesthetic
Religion, in addition to artistic and literary influences, also promoted a
positive image of a consumptive death. Many clergymen and Evangelical
doctors viewed the disease as a “blessing in disguise…[allowing] time and
clarity for spiritual reflection and improvement.”25 Victorian Christians
feared dying from rapidly progressing infectious diseases, because they
25 Jalland, Death in the Victorian Family, 41.
8
prevented one from “the time…[and] mental clarity to make final peace with
God.”26 Surgeon Dr. Samuel Beckett preferred a slow consumptive death to
one from “various fevers, insanity, or sudden accident[s],” and considered
witnessing the “calm, heavenly, and truly edifying bearing” of a young
person slowly dying from tuberculosis to be delightful.27 Hence, the notion
that a consumptive death was a “good death,” whereby dying loved ones
had sufficient time to seek divine retribution.
Even Charles Dickens (1812-1870) romanticized Little Nell’s death by
consumption in his novel The Old Curiosity Shop (1841). The narrator
marvels at how “her early cares, her sufferings, and fatigues” had been
replaced by the birth of “peace and perfect happiness…in her tranquil
beauty and profound repose.”28 Her corpse is portrayed as having
“[overcome] sin and all other signs of difference,” because in her death she
is finally freed from sorrow.29 This scene reassures readers “that death is
the liberation from earthly care” and worthy of an aspirational ideal.30
Dickens may have described the death of a poor, young child as
angelic, but it was the young, beautiful, and pale upper-class woman who
overwhelmingly dominated the consumptive narrative during the mid-
nineteenth century, despite the fact that most consumptive victims were
working class. Popular opinion held that there was a consumptive ‘type’—
26 Ibid.27 Ibid.28 Charles Dickens, The Little Old Curiosity Shop (Harmondsworth: Penguin, 1972), 654. 29 Elizabeth Bronfen, Over Her Dead Body: Death, Femininity and the Aesthetic, (New York: Routledge, 1992), 89. 30 Ibid.
9
certain individuals were more susceptible to contracting consumption than
others. This theory arose during a time when the contagious nature of
tuberculosis was still misunderstood. Koch’s identification of the
tuberculosis-causing tubercle bacillus in 1882 provided evidence that
tuberculosis was infectious, but few people believed in germ theory and its
contagious implications. To many medical professionals, contagion theory
did not explain why tuberculosis often “singl[ed] out certain people and
frequently [left] those in contact with them unscathed.”31 Furthermore,
there was a certain ‘social consideration’ if Koch’s discovery was to be
believed; people would panic at the revelation that these small infectious
bacteria infected anyone, regardless of class or wealth. Far more
comforting was the belief that consumption was largely confined to those
who possessed a hereditary trait making them more susceptible.
Consumptives were not merely individuals who had unluckily “inhaled the
germ, but had been selected for a mysterious reason.”32 This reason was, of
course, broadly interpreted, and many concluded that consumptives were
the pale, young women portrayed in fiction, however true these
representations may have been.
There seemed to be an undeniable correlation between tuberculosis,
appearance, and behavior. During the Victorian period, many believed that
the “most physically attractive members of the population” and “the young
31 Byrne, Tuberculosis and the Victorian Literary Imagination, 22. 32 Ibid., 23.
10
[to be] in some inexplicable way more susceptible” to consumption.33
Despite medical advancements, popular opinion overwhelmingly supported
this perception, which was also upheld and reinforced by the Victorian
medical profession, as Dr. Sealy’s comments in 1837 exemplify:
Phthisis Pulmonalis is characterized in the earlier stages of life, by a peculiar diathesis or external manifestation of constitution. Those indications are a peculiar delicacy of texture and colour of skin, a precocity of intellect, a clear brilliancy of eye and a graceful tenuity of figure, forming in all the most attractive appearance of the human youth of both sexes.34
The consumptive aesthetic entailed dramatic paleness, delicateness,
and thinness. As consumption became increasingly associated with women,
these qualities, along with the “red cheeks and bright eyes of fever”
physically characterized a disease whose sufferers were the sensible,
“refined, intelligent and sensitive members of the upper classes.”35
Sensibility, determined by “the suppleness of the nervous system,” was an
especially important consumptive marker; this suppleness was supposedly
far more common among the middle and upper classes, explaining the close
link between consumptive idealization and the middle and upper classes.36
Seen as pious, angelic, and refined in literature, these qualities emphasized
a woman’s “fragile loveliness,” “sexual attractiveness,” and delicate and
desirable youth.37 33 Ibid., 92.34 Clark Lawlor, Consumption and Literature: The Making of the Romantic Disease (Basingstoke: Palgrave, 2006), 46.35 Byrne, Tuberculosis and the Victorian Literary Imagination, 6. 36 Carolyn A. Day and Amelia Rauser, "Thomas Lawrence’s Consumptive Chic: Reinterpreting Lady Manners’s Hectic Flush in 1794," Eighteenth-Century Studies 49, no. 4 (2016): 460, doi:10.1353/ecs.2016.0030.37 Byrne, Tuberculosis and the Victorian Literary Imagination, 92.
11
The popular photograph by Henry Peach Robinson, Fading Away
(1858), aptly represents the consumptive aesthetic (Fig. 2). A composition
of five negatives, the image generated a fair amount of controversy at the
time of its production because some viewers felt it was an unsuitable
subject to photograph. Nonetheless, the image was widely reproduced and
circulated. Its subject, a young, beautiful girl dying from consumption,
reinforces the belief that the disease’s victims were young and physically
attractive. Her pale skin, illuminated by her white robes, reaffirms the
deathly pallor prevalent among consumptive women. In visual
representations, afflicted individuals, too weak to stand, are usually shown
reclining, adding to their fragility and delicateness. In Robinson’s
photograph, the subject is also clearly wealthy, as evidenced by the elegant
furnishings and draperies in her surroundings, again confining the
consumptive aesthetic to middle and upper class women.
Consumptive Chic: A Damaging Ideal
It is contradictory that a diseasean indicator of poor healthhad become
so desirable. Until consumption was romanticized, no other disease had
been treated in that manner. Unlike syphilis and leprosy, which represented
physical disfigurement, and cancer and gout, which were markers of age,
consumption carried positive social perceptions of femininity and beauty.38
Thomas Rowlandson’s graphic satire Dropsy Courting Consumption (1810)
38 Ibid.
12
caricaturizes two of the era’s medical ailments and their health effects,
juxtaposing the pale wasting away of Consumption with the swollenness of
Dropsy, edema that occurred possibly from congestive heart failure (Fig. 3).
While health was a traditional marker of beauty (and naturally so), the
consumptive aesthetic reversed this pattern as “an illness that beautified as
it destroyed.”39
In fact, out of the consumptive aesthetic arose a ‘consumptive chic’
that became the “defining, fashionable look of the time.”40 Achieving a
consumptive aesthetic brought its sufferers “a superior sensibility” and
“mark of distinction.”41 Victorian women employed often harmful tactics in
pursuit of the consumptive aesthetic that manifested in their dress and
treatment of their bodies. Victorian fashion included the corset, which
“extended downwards over the hips to nip in the waist to the desired
waspish dimensions” and “large-shouldered, puffy gigot sleeves, and
lowered, more defined waists.”42 Women could now be the “languishing
damsels dressed in vaporous white.”43 Women aspiring for consumptive chic
surrendered exercise, relegating themselves to the “dusty housebound
environment” and avoided sunlight and fresh air, creating a class of women
entirely dependent upon nurses and servants for existence.44 These habits
39 Carolyn A. Day and Amelia Rauser, "Thomas Lawrence’s Consumptive Chic”, 460. 40 Byrne, Tuberculosis and the Victorian Literary Imagination, 93.41 Flurin Condrau and Michael Worboys, Tuberculosis Then and Now: Perspectives On the History of an Infectious Disease (Ithaca: McGill-Queen's University Press, 2010), 33.42 Bynum, Spitting Blood, 89.43 Dormandy, The White Death, 91.44 Bram Dijkstra, Idols of Perversity: Fantasies of Feminine Evil in Fin-de-Siècle Culture (Oxford: Oxford University Press, 1986), 28-9
13
ironically also caused many women to contract the very disease they strived
to emulate, carrying their concentrated efforts to grim fruition.
The young women who were too healthy to contract tuberculosis
“came to harbor feelings of guilt” and “an undefined sense of not being as
virtuous as their sisters” who had successfully achieved this appearance.45
Consequently, many drank lemon juice and vinegar to eat less and appear
more alluring.46 These actions, along with purposeful starvation to achieve
the thin and wan consumptive appearance, grew to epidemic proportions in
the 1860s, and are likely “psychological antecedents of our twentieth-
century disease of anorexia nervosa…[that creates] a false sense of virtuous
self-control.”47
The rise of the consumptive aesthetic and the fervent adherence to
these ideals reflected and reinforced normative gender roles. In Idols of
Perversity (1896), Bram Dijkstra identifies a pervasive ‘cult of invalidity’ in
Victorian culture that transformed the lives of middle and upper-class
women in the latter half of the nineteenth century. This ‘cult’ revolved
around attainment of a consumptive aesthetic. After the Romantic period, it
was not enough just to appear “interesting.” Ill health was accepted as the
natural female state; normal health, let alone “unusual physical vigor,” was
unnatural.48
45 Ibid., 29.46 Dormandy, The White Death, 91.47 Dijkstra, Idols of Perversity, 29.48 Dijkstra, Idols of Perversity, 26.
14
As Katherine Byrne argues in Tuberculosis and the Victorian Literary
Imagination, the “natural invalid” served a purpose: to act as the “keeper
and preserver of the masculine soul.”49 For men in a capitalist society, their
struggles for money and power were thought to erode their morality;
consumptive women conveniently juxtaposed their husbands’ moral
degradation. As wives, upper and middle class women who stayed at home
became a refuge “unblemished by sin and unsullied by labor,” “protect[ing]
her husband’s soul from permanent damage…The very intensity of [female]
purity and devotion would regenerate” the “war-scarred tissue” of a man’s
soul eroded by the “moral pitfalls inherent in the world of commerce.”50 For
a wife to become a virtuous keeper of male morality, she had to stay
removed from worldly concerns and bodily desires. Invalidism conveniently
served answered this cry for help, because no one was further removed
from “worldiness, sin or lustful corporeality than the incapacitated,
resignedly suffering woman confined to her sickroom.”51
Economic reasons also justified women’s relegation to the role of the
frail, consumptive invalid. A sick wife indicated wealth. The bourgeois
capitalist could demonstrate his financial success by supporting a
consumptive wife who could not contribute financially, but rather, merely
drain the household finances.52 This perceived female role was damaging
because it supported the notion among the wealthy that women belonged in
49 Byrne, Tuberculosis and the Victorian Literary Imagination, 95. 50 Dijkstra, Idols of Perversity, 8.51 Byrne, Tuberculosis and the Victorian Literary Imagination, 95. 52 Ibid.
15
the home; they had no need to pursue their own careers. Thus, feminine
invalidism, which “had become a veritable cult among the women of the
leisure class,” increased gender inequality in terms of men and women’s
contributions to society. 53
Conclusion
From the reinforcement of normative gender roles to the demands of
capitalism, the advocacy of ill health, supported by a clear social
investment, certainly propagated illness among women during the
nineteenth century. Invalidism as the result of a slew of illnesseschiefly
tuberculosishad become a deeply ingrained way of life. Tuberculosis and
conformity to the consumptive aesthetic was the vehicle through which
women could show off the “most desirable female characteristics, namely
purity, passivity, and a willingness to sacrifice oneself for others, especially
men.”54 As aptly put by Byrne,
The invalid women’s weakness of body meant that she was entirely and suitably dependent on others for physical, emotional and financial support and yet her patient endurance of pain proved her strength of soul. Hence sickness came to signify virtue, and the sickly woman became the ideal woman.55
The idealization of tuberculosis during the nineteenth century can be
explained with reference to its Romantic Era associations with intellectually
53 Dijkstra, Idols of Perversity, 27.54 Byrne, Tuberculosis and the Victorian Literary Imagination, 95.55 Ibid.
16
gifted men like John Keats and Frédéric Chopin, followed by literary
representation in novels such as Charles Dickens’ The Old Curiosity Shop.
During the Victorian period, tuberculosis became primarily a feminine
concern as women suffered to achieve a tubercular aesthetic. While female
conformity to consumptive fashion reflected changing social ideals of
beauty, the consumptive aesthetic – seen in Robinson’s image Fading Away
– as the paragon of Victorian beauty, had sinister effects on its followers.
The consumptive woman reinforced the ideal of feminine invalidism,
perpetuating normative gender roles. Consumptive chicness and the
consumptive aesthetic reinforced the conviction that women should be
relegated to the domestic sphere as keepers of masculine morals. Thus,
long-lasting and pervasive social perceptions of tuberculosis reinforced
female gender roles and cemented the inferior social status of women in
Victorian society.
Images
Fig. 1. Félix-Joseph Barrias, Death of Chopin, 1885. Oil on canvas, 43.3 x 51.6 in. Kraków National Museum, Kraków, Poland.
17
Fig. 2. Henry Peach Robinson, Fading Away, 1858. Albumen silver print from glass negatives, 9 3/8 x 14 5/8 in. The Royal Photographic Society Collection at the National Media Museum, Bradford, United Kingdom.
Fig. 3. Thomas Rowlandson, Dropsy Courting Consumption, 1810. Hand-colored etching, 13 3/8 x 9 1/16 in. The Elisha Whitelsey Collection at the Metropolitan Museum of Art, New York, United States.
Bibliography
Bronfen, Elizabeth. Over Her Dead Body: Death, Femininity, and the Aesthetic. New York: Routledge,
1992.
Bynum, Helen. Spitting Blood: The History of Tuberculosis. Oxford: Oxford University Press, 2012.
Byrne, Katherine. Tuberculosis and the Victorian Literary Imagination. Cambridge: Cambridge University
Press, 2011.
Condrau, Flurin, and Michael Worboys. Tuberculosis Then and Now: Perspectives on the History of an
18
Infectious Disease. Ithaca: McGill-Queen's University Press, 2010.
Day, Carolyn A., and Amelia Rauser. "Thomas Lawrence’s Consumptive Chic: Reinterpreting Lady
Manners’s Hectic Flush in 1794." Eighteenth-Century Studies 49, no. 4 (2016): 455-74. doi:10.1353/ecs.2016.0030.
Dickens, Charles. The Old Curiosity Shop. Harmondsworth: Penguin, 1972.
Dijkstra, Bram. Idols of Perversity: Fantasies of Feminine Evil in Fin-de-Siècle Culture. Oxford: Oxford
University Press, 1986.
Dormandy, Thomas. The White Death: A History of Tuberculosis. New York: New York University
Press, 2000.
Jalland, Pat. Death in the Victorian Family. Oxford: Oxford University Press, 2000.
Keats, John. John Keats: The Major Works: Including Endymion, the Odes and Selected Letters (Oxford World's
Classics). Oxford: Oxford University Press, 2009.
Lancet, 30 Sept. 1882.
Lawlor, Clark. Consumption and Literature: The Making of the Romantic Disease. Basingstoke: Palgrave,
2006.
Lawn, Stephen D. and Alimuddin I. Zumla. "Tuberculosis." The Lancet 378, no. 9785 (Jul, 2011): 57-
72.http://proxy.library.georgetown.edu/login?url=http://search.proquest.com/docview/874571407?accountid=11091.
Skolnik, Richard L. Global Health 101. Burlington, MA: Jones & Bartlett Learning, 2012.
19