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.

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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.

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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

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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.

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“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.

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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.

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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.

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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.

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[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.

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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

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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.

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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.

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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.

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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.

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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.

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