The Victorian Woman Writer Who Refused to Let Doctors Define Her

Harriet Martineau took control of her medical care, defying the male-dominated establishment’s attempts to dismiss her as hysterical and fragile

Illustration of Harriet Martineau in front of pages from "Life in the Sick-Room"
“Martineau was extremely unusual in the amount of control she had over her own medical care,” says Rachel Ablow, author of the 2017 book Victorian Pain. Photo illustration by Meilan Solly / Photos via Wikimedia Commons and Google Books under public domain

The pain struck suddenly in Venice.

Writing to her doctor brother-in-law in 1839, famed British writer Harriet Martineau complained of the “inability to stand or walk, aching and weariness of the back, extending down the legs to the heels” and “tenderness and pain, on pressure, in the left groin, extending by the hip to the back.” She’d been traveling through Europe with a group of friends for several months, but now it seemed the completion of her adventures would have to be put on hold.

Within weeks, Martineau was back in England, where she was diagnosed with a retroverted uterus and polypus tumors: two vaguely defined conditions without a cure. (These ailments would likely be diagnosed differently today, but modern scholars often shy away from definitively diagnosing historical figures due to the difficulty of doing so with limited information.) As for treatments, the most Martineau could hope for was iodide of iron for “purifying the blood,” morphine for the pain and the general cure-all treatment of bloodletting. Resigning herself to an illness of unknown duration, Martineau moved to Tynemouth, a town on the northeastern coast of England, and hired nurses and servants to care for her in this new sickroom. She would remain there for the next five years, largely unable to leave due to the pain of walking.

The Victorian Woman Writer Who Refused to Let Doctors Define Her
Martineau in her later years, as painted by artist George Richmond Public domain via Wikimedia Commons

For all her suffering, Martineau remained an active writer for decades—and she kept control of her own medical treatment. In a period when women were viewed as the weaker sex, both physically and intellectually, Martineau asserted her right to manage her own body and its care.

Though she was only 37 when she received her diagnosis in 1839, Martineau was no stranger to poor health. As a child, she suffered from digestive complaints and partial deafness. One of eight children born into a middle-class manufacturing family, Martineau was left without an inheritance after her parents lost their business in 1829. Instead of finding a husband to provide for her, she began writing.

At first, Martineau covered religion and women’s education for various publications. Then, in 1832, she shifted gears, publishing the first volume of Illustrations of Political Economy, a collection of short stories that meditated on social and scientific theories expounded by intellectuals like James Mill, Thomas Malthus and Adam Smith. Over the course of two years, she authored 24 immensely successful volumes. By 1834, up to 10,000 copies of the book were selling every month—a number five times higher than the rate at which Charles Dickens’ novels were selling. Martineau had not only secured herself a steady income but also cemented her status as one of Britain’s most popular intellectuals.

Following the success of her books, Martineau pursued a career as a wide-ranging journalist and author. She traveled to the United States and wrote passionately against slavery, as well as more generally on social and cultural practices in the country. She published How to Observe, a book now considered the first treatise on the practice of ethnography. She penned her first novel, Deerbrook, and was in correspondence with many of the most renowned thinkers of the day, from Ralph Waldo Emerson to Elizabeth Barrett Browning. By the time Martineau took to her sickroom in the fall of 1839, she had both the money and the social clout to dictate what kind of treatment she would receive.

“Martineau was extremely unusual in the amount of control she had over her own medical care,” says Rachel Ablow, author of the 2017 book Victorian Pain and an expert on English literature and culture at the University of Buffalo. “She was very much in the driver’s seat, and that was pretty much unheard of for women at the time. But it was becoming more unusual for patients in general because of changes in the medical profession.”

Victorian Pain

"Victorian Pain" offers a compelling new literary and philosophical history of modern pain.

The 1840s were a strange, turbulent time for the practice of medicine. Opiate-based medications offered true pain relief, and the advent of anesthesia made surgical procedures not only more survivable but also less horrific. Doctors had begun calling for reforms that would distinguish between true medical practitioners and quacks. They wanted laws to standardize care. They also wanted to be viewed as medical professionals who could insist on their expertise at the expense of a patient’s own account. As Alison Winter, a historian of science and medicine, wrote in 1995, “The doctor’s professional duties lay in mistrusting what his patient told him. Indeed, the patient had no means of understanding the truth of ... bodily affairs, because [they were] ignorant of the true nature of internal organs.”

Martineau was by no means averse to medicine becoming a more scientific practice. But she refused to let herself be defined as nothing more than a diseased body. In addition to writing regularly to her literary friends throughout her illness, Martineau published a children’s novel in 1841 and an anonymous collection of essays titled Life in the Sick-Room in 1844. Though her name wasn’t associated with the book, it was widely known that Martineau had written it. Once again, the volume was a best seller, adopting a very different approach from other writings on the subject.

The Victorian Woman Writer Who Refused to Let Doctors Define Her
1872 oil painting of a woman in bed in a sickroom, attended by a physician Wellcome Collection under CC BY 4.0

“The experience of the sickroom was very normal for Victorians,” says Maria Frawley, an expert on English literature and culture at George Washington University who edited a recent edition of Martineau’s book. “Most Victorians had the experience of family members being confined to a sick bed for protracted periods of time.”

These sickrooms weren’t the Victorian equivalent of modern hospice care, as patients weren’t necessarily dying. Rather, the sickroom was a place for someone experiencing a prolonged recovery or incurable disease, a room that might be equipped with specially designed beds and other medical implements that family members could use to care for the invalid.

As a result, “invalid writing” flourished, usually in the form of prayer books and hymnals to encourage the sufferer or guides for those visiting the patients on how to encourage the sick. Martineau took a completely different tack, writing about such topics as the benefits of being away from one’s family, truths that are more apparent to the ill than to the healthy and how others’ sympathy can become rancorous for the patient.

The Victorian Woman Writer Who Refused to Let Doctors Define Her
Harriet Martineau, painted in 1834 by Richard Evans Public domain via Wikimedia Commons

“It does a pretty striking analysis of what we now call the ‘emotional labor’ expected of the invalid, how the invalid is expected to manage the emotions of people taking care of her and how much of a drain that is,” says Ablow. “The book is a fascinating account of the psychology of long-term illness and the interpersonal dynamics around long-term illness.”

Martineau arranged her room with specific books and paintings, as well as a window overlooking the water and a telescope. Even though she had strict control over who visited her—an exception to the general rule of invalids being unable to choose who came to see them—she never hid her illness from the public. Instead of bowing to the dominant social belief that women were fragile, hysterical beings especially prone to illness, Martineau insisted that her experience as an invalid made her more knowledgeable and authoritative.

This argument, of course, did not go over well with the medical community. Though literary circles largely praised Life in the Sick-Room, an anonymous essayist writing in the British and Foreign Medical Review concluded that Martineau’s book was proof that she suffered from nervous exhaustion or hysteria. According to Winter, “In lieu of the patient, he performed a medical examination upon her book.”

The medical establishment turned even more acrimonious when Martineau experienced a cure (or at least a significant improvement of symptoms) after undergoing Mesmerism in the summer and fall of 1844, shortly after writing and publishing Life in the Sick-Room. Developed in the late 1700s by Austrian physician Franz Anton Mesmer, the treatment purportedly involved the manipulation of invisible forces between people. Also known as “animal magnetism,” the idea was that a person could be healed by readjusting the flow of an invisible internal fluid. Modern observers might now call Mesmerism a form of hypnotism; at the time, many viewed it as a potentially viable treatment—among them Martineau, whose pain was dramatically reduced after being treated by her maid (yet another example of the writer rejecting the establishment, as the majority of Mesmeric practitioners were men).

The Victorian Woman Writer Who Refused to Let Doctors Define Her
Wood engraving of mesmerism treatment for a woman suffering from convulsions Public domain via Wellcome Collection

Now fully recovered and once more able to walk and move without pain, Martineau published “Letters on Mesmerism” in the November and December 1844 issues of the Athenaeum, a gentleman’s weekly. In these essays, she argued in favor of studying Mesmerism more scientifically and gauging if the practice could be explained and replicated.

For many doctors, including Thomas Michael Greenhow, Martineau’s brother-in-law, who had been overseeing her care, such claims about Mesmerism were untenable. Though Greenhow had initially accepted the Mesmeric treatment for Martineau, he now felt it to be an attack on his medical expertise. To defend himself, Greenhow published a full report on Martineau’s illness in early 1845. The case study appeared not in a medical journal but as a general pamphlet for the public. It barely attempted to anonymize its subject, calling her simply “H.M.” Not only did Greenhow publish intimate details of his sister-in-law’s condition, he added, “I always believed that a time would arrive when my patient would be relieved from most of her distressing symptoms.”

Unsurprisingly, Martineau was furious at this breach of privacy. Though she had consented to her case being written up, she thought it would appear anonymously in a medical journal. Instead, it was “not even written in Latin—but open to all the world!” as she said. (Latin was the lingua franca for scientific and medical publications until the early 19th century, when scholars began writing in the vernacular.) Martineau broke off all contact with Greenhow, left her sickroom in Tynemouth, and resumed traveling and writing once more.

That wasn’t the end of her ordeal. In 1855, Martineau once again confined herself to a sickroom due to a resurgence of her symptoms. She remained there for much of the next 20 years, continuing to write prolifically throughout her convalescence. Among other works, she wrote an autobiography; a historical treatise that both criticized imperialism and advocated for British rule in India; and a collection of articles titled Health, Husbandry and Handicraft. She also petitioned for woman’s suffrage and campaigned against the Contagious Diseases Act, which targeted prostitutes (and women more generally) in the name of reducing sexually transmitted illnesses.

She was very much in the driver’s seat, and that was pretty much unheard of for women at the time.

“By authorizing gratuitous arrest and gynecological examination of any woman suspected of prostitution, these acts, as Martineau explained, jeopardized the civil liberties of all women, unjustly punishing ‘the sex who are the victims of a vice’ rather than ‘the sex who are the main cause, both of the vice and its dreaded consequences,’” wrote gender studies scholar Anka Ryall in 2000.

Martineau died in 1876 at the age of 74, having published 35 books and numerous essays over the course of her career. With her death came the publication of her autobiography, in which she discussed her illnesses and even made disparaging remarks about Life in the Sick-Room, finding this earlier work to be too self-indulgent. She still insisted on the need for patients to be in control of their care, leading doctors to once again leap to defend themselves.

Shortly after Martineau’s death, prominent surgeon Thomas Spencer Wells presented the results of her autopsy in front of the Clinical Society of London, despite being unconnected to Martineau or the doctor who conducted the autopsy. Instead, Wells had gained renown for performing nearly 1,000 ovariotomies—a surgery to remove diseased ovaries. He noted that Martineau had a cyst measuring 30 inches by 28 inches in circumference. (Ovarian cysts vary in size, but most are smaller than three inches long, making Martineau’s cyst exceptionally large.) It had filled two-thirds of her abdomen, squashing many of her internal organs.

Greenhow, who had helped make Martineau’s autopsy report public without her permission, claimed that her gynecological disease was the reason for her unfeminine behavior and opinions. Wells agreed, adding, “We must regret the more that the last twenty years of the life of this remarkable woman were not made as happy as they might have been by the removal of the cyst which was removed so easily after her death.” What Wells didn’t mention was that ovariotomy surgeries had a mortality rate of 70 to 80 percent before 1860.

The Victorian Woman Writer Who Refused to Let Doctors Define Her
In this 19th-century watercolor by R.H. Giles, a girl reads to an invalid while a nurse brings in the patient's medicine. Wellcome Collection under CC BY 4.0

Commenting on Wells’ presentation, Ryall wrote, “It was important to establish clear distinctions between ‘true’ sciences increasingly practiced by men defining themselves as specialist professionals, and popular science, or pseudoscience, such as Mesmerism, that [was] appropriated and promiscuously disseminated by the unlearned of either sex, and most problematically perhaps, by some educated middle-class women who ought to have known better.”

For Ablow, the doctors’ posthumous attack on Martineau offers “a certain patronizing sense of [them arguing that] this woman [is] less powerful than she thinks. It can also serve as a real warning to other women who want to speak out about their medical care or illness in general.”

Despite all the success and critical acclaim Martineau achieved in her lifetime, she has largely been forgotten, especially compared to contemporaries like Charlotte Brontë and George Eliot. Neither Ablow nor Frawley have an explanation for Martineau’s relative obscurity; sometimes, writers simply disappear from the canon.

All the same, Martineau was a remarkable example of a writer who didn’t hide from or obscure her illness and disability. Instead, those experiences gave her the strength to push back against Victorian paradigms of illness and health, strength and weakness, feminine and masculine—and to leave an indelible mark on her culture.