Harriet Martineau took control of her healthcare, ignoring male-dominated institutions trying to see her as hysterical and vulnerable

Sudden pain struck in Venice.

In 1839, the famous British writer Harriet Martineau wrote to her doctor’s brother-in-law, complaining about “unable to stand or walk, back pain and fatigue, legs extending to the heel” and “tenderness and pain”. In the left groin, it extends from the hip to the back. "She and a group of friends traveled in Europe for several months, but now it seems that her adventure has to be put on hold.

A few weeks later, Martineau returned to England, where she was diagnosed with retroverted uterus and polyps: two vaguely defined diseases that cannot be cured. (These diseases may have different diagnoses today, but modern scholars often avoid the diagnosis of historical figures, because it is difficult to do this with limited information.) As for treatment, Martino's most hope is iron iodide , Used to "purify the blood," morphine is a general panacea for pain relief and bloodletting​​​​ Martino resigned due to an illness of unknown duration, moved to Tynemouth, a small town on the northeast coast of England, and hired nurses and servants to take care of her in this new ward. For the next five years, she will stay there, and due to the pain of walking, she can hardly leave.

Despite all the suffering, Martino has been an active writer for decades-she controls her medical care. At a time when women were seen as physically and intellectually weaker sexes, Martineau claimed that she had the right to manage her body and its care.

Although she was only 37 years old when she was diagnosed in 1839, Martino was no stranger to poor health. As a child, she suffered from digestive diseases and partial deafness. Martineau was one of eight children born in a middle-class manufacturing family and lost her inheritance after her parents lost their business in 1829. Instead of finding her husband to feed her, she started writing.

At first, Martino reported on religion and women's education for various publications. Then, in 1832, she changed direction and published the first volume of "Illustrations of Political Economy", a collection of short stories thinking about social and scientific theories, written by James Mill, Thomas Malthus, and Adam Smith. And other intellectuals explained. In two years, she created 24 very successful works. By 1834, the book sold 10,000 copies per month—five times the sales of Charles Dickens’ novels. Martino not only earned a steady income for herself, but also consolidated her position as one of the most popular intellectuals in the UK.

After the success of her book, Martineau began a career as a wide-ranging journalist and writer. She traveled to the United States and wrote passionately against slavery and more generally about the country’s social and cultural customs. She published How to Observe, and this book is now considered the first essay on the practice of ethnography. She wrote her first novel Deerbrook and corresponded with many of the most famous thinkers of the time, from Ralph Waldo Emerson to Elizabeth Barrett Browning. By the fall of 1839, when Martineau entered the ward, she had both money and social influence to decide what kind of treatment she would receive.

"The degree of Martino's control over his health care is very unusual," said Rachel Ablow, author of the book "Victorian Pain" published in 2017 and an expert on English literature and culture at the University of Buffalo. ) Say. "She was very sitting in the driver's seat, which was almost unheard of for women at the time. But due to changes in the medical industry, this situation has become increasingly unusual for the average patient."

"Victorian Pain" provides a fascinating new history of modern pain literature and philosophy.

The 1840s was a strange and turbulent period for medical practice. Opioid-based drugs can really relieve pain, and the advent of anesthesia has made surgery not only easier to survive, but also less terrible. Doctors began to call for reforms to distinguish true doctors from quack doctors. They hope to pass laws to regulate nursing. They also want to be regarded as medical professionals who can maintain their expertise at the expense of the patients' own interests. As the scientific and medical historian Alison Winter wrote in 1995, “The professional duty of a doctor is not to believe what the patient tells him. Indeed, the patient has no way to understand... the truth about the body. Because [they] don’t know the true nature of the internal organs."

Martineau has no objection to medicine becoming a more scientific practice. But she refused to allow herself to be defined as a sick person. In addition to regularly writing letters to her literary friends during her illness, Martino also published a children's novel in 1841, and in 1844 published a collection of anonymous essays called "Life in the Ward". Although her name has nothing to do with this book, it is widely used to know that it was written by Martino. This book became a bestseller again, using a completely different approach from other works on the subject.

"For Victorians, the ward experience is very normal," said Maria Frawley, an English literature and culture expert at George Washington University, who edited Martino's most recent edition of the book. "Most Victorians have had their family members confined to hospital beds for a long time."

These wards are not modern hospice care in the Victorian era, because patients do not necessarily die. More precisely, a ward is a place for those who have experienced long-term recovery or incurable diseases. A room may be equipped with specially designed beds and other medical appliances that family members can use to care for the sick.

As a result, "invalid writing" prevails, usually in the form of prayer books and hymns to encourage patients or to instruct patients on how to encourage them. Martino took a completely different approach, writing about topics such as the benefits of being away from his family, the truth that is more obvious to patients than to healthy people, and how other people's sympathy is hostile to patients.

"It is a very amazing analysis of what we now call the'emotional labor' expected of the patient, how the patient should manage the emotions of the person taking care of her, and how much it consumes," Ablow said. "This book provides a fascinating description of the psychology of chronic illness and the dynamics of interpersonal relationships with chronic illness."

Martino arranged certain books and paintings in her room, as well as a window overlooking the water and a telescope. Although she has strict control over who visits her-this is an exception to the general rule that people with disabilities cannot choose who to visit-she never hides her condition from the public. Martino did not succumb to the mainstream social belief that women are vulnerable and hysterical people are particularly vulnerable to illness, but insisted that her experience as a patient made her more knowledgeable and authoritative.

Of course, this argument has not been recognized by the medical community. Although the literary world generally praised life in the ward, an anonymous essayist in British and foreign medical reviews concluded that Martino's book proved that she was suffering from nervous breakdown or hysteria. According to Winter, "He took the place of the patient and performed a medical examination of her book."

In the summer and autumn of 1844, shortly after the writing and publishing of "Life in the Ward", Martineau received hypnotic treatment, and the medical institution became more intense. This therapy was developed by the Austrian physician Franz Anton Mesmer in the late 1700s and allegedly involves manipulating invisible forces between people. Also known as "animal magnetism", the idea is that a person can be healed by re-adjusting the flow of an invisible internal fluid. Modern observers may now refer to hypnotism as a form of hypnotism; at the time, many people thought it was a potentially viable treatment—including Martineau, whose pain was greatly reduced after her maid’s treatment (The author rejects another example of this institution because most hypnotism practitioners are men).

Martino has now fully recovered and is able to walk and move painlessly again. He published "Letters on Hypnotism" in the November and December 1844 issue of the Gentleman's Weekly Athena. In these articles, she advocates a more scientific study of hypnotism and measures whether this practice can be explained and replicated.

For many doctors, including Martineau’s brother-in-law Thomas Michael Greenhow, who has been supervising her care, this claim of hypnotism is untenable. Although Greentree initially received the hypnotherapy for Martino, he now feels that it is an attack on his medical expertise. In order to defend himself, Greentree published a complete report on Martino's condition in early 1845. The case study did not appear in a medical journal, but as a general brochure for the public. It hardly tried to anonymize its subject, simply calling her "HM" Green Howe not only disclosed the private details of his sister-in-law’s condition, he added, "I have always believed that my patients will be the most painful from her. symptom."

Unsurprisingly, Martineau is angry at this invasion of privacy. Although she agreed to record her case, she believes it will appear anonymously in medical journals. On the contrary, it “is not even written in Latin—it is open to the whole world!” As she said. (Latin was the lingua franca of scientific and medical publications until the early 19th century, when scholars began to write in the vernacular.) Martineau severed all contact with Greenhow, left her ward in Tynemouth, and started again Travel and writing.

Her ordeal is not over yet. In 1855, Martino locked himself in the ward again due to recurrence of symptoms. For most of the next 20 years, she stayed there and continued to write extensively during her recovery. Among other works, she wrote an autobiography; a historical essay that both criticized imperialism and advocated British rule in India; and a collection of articles entitled "Health, Animal Husbandry, and Handicraft." She also requested women’s right to vote and opposed the Infectious Diseases Act, which targets prostitutes (and women more generally) in the name of reducing sexually transmitted diseases.

She was very sitting in the driver's seat, which was almost unheard of for women at the time.

"By authorizing the unreasonable arrest and gynecological examination of any woman suspected of prostitution, as Martino explained, these actions endanger the civil liberties of all women and unfairly punish the'gender as a victim of vice' instead of 'Persecuted gender'. The main reasons include vices and their terrible consequences," wrote gender scholar Anka Ryall in 2000.

Martino died in 1876 at the age of 74 and published 35 books and numerous papers during her career. With her death, her autobiography was published, in which she discussed her illness, and even made derogatory remarks about life in the ward, thinking that this early work was too self-indulgent. She still insisted on letting patients control their own care, and made the doctors eager to try again and defend themselves.

Soon after Martineau's death, the famous surgeon Thomas Spencer Wells presented her autopsy results in front of the London Clinical Society, although there was no contact with Martineau or the doctor who performed the autopsy. On the contrary, Wells gained fame for performing nearly 1,000 ovariectomies-an operation to remove diseased ovaries. He pointed out that Martineau has a cyst measuring 30 inches x 28 inches in circumference. (Ovarian cysts vary in size, but most are less than 3 inches long, which makes Martineau's cysts particularly large.) It has filled two-thirds of her abdomen, squeezing many of her internal organs.

Greentree helped release Martino's autopsy report without her permission, claiming that her gynecological disease was the reason for her unfeminized behavior and opinions. Wells agreed, adding: "We must be even more regretful that this outstanding woman was not as happy in the last 20 years of her life as when she had a cyst removed so easily after her death." Wells did not It is mentioned that before 1860, the mortality rate of oophorectomy was 70% to 80%.

Commenting on Wells’ speech, Ryle wrote: “It is important to clearly distinguish between more and more men who define themselves as the'real' science practiced by professionals from popular science or pseudoscience, such as hypnotism, The [being] misappropriated and mixed are spread by people who don’t understand any gender. Perhaps the most problematic are some educated middle-class women who should have known more.”

For Ablow, the doctor’s post-mortem attack on Martino provided “[they argued] this woman [not] a certain sense of patronage as powerful as she thought. It can also really warn others who want to talk about themselves Women with health care or illness."

Although Martino has achieved all the success and praise in her life, she has been largely forgotten, especially when compared with contemporaries like Charlotte Bronte and George Eliot. Compare. Neither Ablow nor Frawley explained Martineau's relative obscurity. Sometimes, the writer simply disappears from the classics.

Despite this, Martino is an outstanding writer, and she has not concealed or concealed her illness and disability. On the contrary, these experiences gave her the power to resist the Victorian paradigm of disease and health, strength and weakness, women and men, and left an indelible mark on her culture.

Lorraine Boissoneault is a contributor to SmithsonianMag.com, covering history and archeology. She has previously written for "The Atlantic", "Salon", "Nautilus" and other magazines. She is also the author of The Last Voyager: Tracing Lassalle's Journey Through America. Website: http://www.lboissoneault.com/

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