“He had fallen in an epileptic fit. As is well known, these fits occur instantaneously. The face, especially the eyes, become terribly disfigured, convulsions seize the limbs, a terrible cry breaks from the sufferer, a wail from which everything human seems to be blotted out, so that it is impossible to believe that the man who has just fallen is the same who emitted the dreadful cry. It seems more as though some other being, inside the stricken one, had cried. Many people have borne witness to this impression; and many cannot behold an epileptic fit without a feeling of mysterious terror and dread” (Dostoyevsky 2005: 260).

The above abstract from Fyodor Dostoyevsky’s masterly novel The Idiot (1869) describes very lively the usual character of epileptic seizures, as well as people’s common feelings towards them, on the occasion of their recurrence to Prince Myshkin. Prince Lev Nikolayevich Myshkin is a good-natured and naïve young man, the “positively good man”, who is suffering from epilepsy and is returning to Russia, after a four-year stay in Switzerland for treatment. As it is clearly stated by the title of Dostoyevsky’s novel, Prince Myshkin is treated with contempt by his environment, due to the peculiarity of his illness; in fact, he is treated as a mentally defective – that is, as an idiot. As a result, his life is presented by the great novelist as the absolute tragicomedy. Even Prince Myshkin himself seems, from time to time, to be aware of this awkward and difficult situation: “I am always afraid of spoiling a great Thought or Idea by my absurd manner. I have no eloquence, I know. I always make the wrong gestures – inappropriate gestures – and therefore I degrade the Thought, and raise a laugh instead of doing my subject justice. I have no sense of proportion either, and that is the chief thing. I know it would be much better if I were always to sit still and say nothing” (Dostoyevsky 2005: 633).

Without doubt, Dostoyevsky’s choice to devote a two-volume novel to epilepsy should not be regarded as accidental. It is widely known that Dostoyevsky himself was suffering in his adult life from frequent epileptic seizures¹ – approximately, one every three weeks – and that he used to confront them with special ambivalence, intense fear and, sometimes, guilt (Rice 1983).² Only half a year after a particularly severe seizure that marked the beginning of his first marriage, he admitted in a letter to Zhdan-Pushkin (29 July 1857) that he was suffering from “a rather dangerous disease – falling sickness”, while some years later he admitted to his second wife that the reason why he had never sought treatment was because he regarded epilepsy as a totally incurable condition (Rice 1983: 147, 152).

However, the issue is neither to proceed to a psychoanalytic reading and interpretation of The Idiot, nor to evaluate it in reference to Dostoyevsky’s personal experience. Apart from an insight into some major points of the author’s thoughts concerning his own physical and mental suffering, the above abstracts and, eventually, the whole novel are indicative of both epilepsy’s distinctive character and the nineteenth-century reactions and feelings towards it. Of course, the historical circumstances in the Russian Empire differed essentially from those in nineteenth-century Britain, which is going to be the focus and reference point of our book. Nonetheless, this significant differentiation does, in no way, negate the huge and novel interest in epilepsy and the significance of its emergence as a purely neurological disorder, during the second half of the nineteenth century. So, before moving on to the main scope of this book, that is, to the analysis of the medical files of John Hughlings Jackson’s epileptic patients, it would be necessary to refer briefly to the general historical conditions in England, during the period under examination, in order to be able to understand the specific role of the National Hospital for the Paralysed and Epileptic and to inscribe epilepsy within the broader historical context.

“It was a town of red brick, or of brick that would have been red if the smoke and ashes had allowed it; but as matters stood, it was a town of unnatural red and black like the painted face of a savage. It was a town of machinery and tall chimneys, out of which interminable serpents of smoke trailed themselves for ever and ever, and never got uncoiled. It had a black canal in it, and a river that ran purple with ill-smelling dye, and vast piles of building full of windows where there was a rattling and a trembling all day long, and where the piston of the steam-engine worked monotonously up and down, like the head of an elephant in a state of melancholy madness. It contained several large streets all very like one another, and many small streets still more like one another, inhabited by people equally like one another, who all went in and out at the same hours, with the same sound upon the same pavements, to do the same work, and to whom every day was the same as yesterday and tomorrow, and every year the counterpart of the last and the next” (Dickens 2005: 25).

In 1854, Hard Times, Dickens’s tenth novel, was published.³ It was during these years when the industrial city of Preston in north-west England – the city that had been Dickens’s model to illustrate his imaginary city of Coketown – had been the heart of political and social radicalism. Therefore, Coketown’s colourful description was mainly an attempt to understand and explain the intense labour activity and mobilisation in the city of Preston, during this period. For, even though the above excerpt is actually an artefact created by Dickens’s imagination and literary pen, it does, to an extent, constitute a realistic illustration of the monotonous routine and harsh reality that the majority of working people did, in fact, experience after the advent of the so-called “Industrial Revolution” in nineteenth-century Britain. Despite the several criticisms, both positive and negative, that Hard Times has received,⁴ it is rather difficult to deny the fact that Dickens’s work does offer to the twenty-first-century reader significant information about the conditions that prevailed in Victorian cities. But, at this point, let us supplement literature by listening to the voice of history.

“What does the phrase ‘the Industrial Revolution broke out’ mean? It means that some time in the 1780s, and for the first time in human history, the shackles were taken off the productive power of human societies, which henceforth became capable of the constant, rapid and up to the present limitless multiplication of men, goods and services. This is now technically known to the economists as the ‘take-off into self-sustained growth’” (Hobsbawm 1996: 28). It is this particular phrase that the British historian Eric Hobsbawm chose to summarize the emergence of the Industrial Revolution. He did by no means imply that this historical phenomenon had been a single moment or a unique incident in the course of human history with a very specific beginning and a very specific end. On the contrary, he conceived the Industrial Revolution as a historical, evolutionary process that began in England during the 1780s and was, to a great extent, completed – as far as England was concerned – until the 1840s.⁵ Besides, already in the 1830s and 1840s, there was noted the “first general stumbling of the industrial capitalist economy” (Hobsbawm 1996: 38). Therefore, it would be interesting to briefly examine the changes and transformations during the period 1780–1840, and accordingly, their consequences upon people’s lives, especially, during the second half of the nineteenth century, when Britain had been transformed into the “workshop of the world”.

During the period 1780–1840, English society was experiencing a deep transformation (Hobsbawm 1995, 1996; Polanyi 2001). Of course, this does by no means imply that it was a process ex nihilo. Despite the obviously significant differentiations, the industrial evolution and development of the majority of European countries – especially, England – was based upon already existent bases (Duplessis 1997; Dowd 2000).⁶ So, within the specific historical conditions of the first half of the nineteenth century, market economy began to expand and consolidate itself at an almost breakneck speed.⁷ Already in the 1820s, economic liberalism, which had emerged as the necessary precondition and basic principle of the unhindered function of market economy, formulated its three vital rules: labour market, international gold standard and free trade. Undoubtedly, this transition from a regulated to a self-regulated market blazed a new trail, leading to deep social, as well as cultural and epistemological transformations, and causing major ruptures within social structures and bonds, by setting human bodies, as well as land and goods, at its disposal (Polanyi 2001).

A without precedent population explosion took place that was accompanied by a significant rise in urban, industrial population and a concomitant decline in rural population.⁸ Simultaneously, transfers and communications were highly facilitated, leading to intense commercial, as well as migratory activities (Hobsbawm 1996).⁹ Mainly, through the remarkable advance of cotton industry,¹⁰ export trade – in contrast to domestic trade – began to flourish and the British colonial spread was in full growth. Moreover, this extremely fast pace of economic growth offered new job opportunities. In this way, it gave a strong impetus to those professionals, who, having as their only asset their personal abilities and labour power, and not their wealth and gentle origin, had the opportunity to ascend the social ladder. They were those people who led to the formation of the so-called “middle class”¹¹ and who “fulfilled their function by developing an all but sacramental belief in the universal beneficence of profits, […]” (Polanyi 2001: 139).

Of course, not everyone was actually favoured by these sudden and swift transformations. Already, in the 1830s, the notion of “class”, with quite ambiguous meaning and use, along with the notion of “hierarchy”, constituted an inextricable part of the discussions regarding the conditions within British society, obtaining gradually a strongly political orientation (Cannadine 1998; Jones 1983). Within this rapidly changing context, the working class was constituted as a separate political and social category, being defined in both political and economic terms (Polanyi 2001).¹² Moreover, the first serious crisis of the capitalistic economy during the 1830s and 1840s induced high unemployment and a harsh decline of real wages, leading to poor living conditions, hardship and privation, to the imminent danger of epidemic diseases and to the more general physical and mental devastation, especially, of those belonging to the lower social strata. All these gave birth to a growing wave of reactions in accordance with a lasting and well-established tradition,¹³ including a variety of forms of resistance; namely, the coordinated destruction of the machines by the Luddites, especially, during the years 1811–1812, 1816, 1822, 1826 and 1830, along with the massive incidents of alcoholism, the riots over food during the years 1795–1796, 1799–1801, 1810–1813 and 1816–1818, the “factory tumults” in northern England in the 1830s and the more general turbulence during the period 1830–1832 in the rest of the country, and, of course, both Robert Owen and the Chartist movement, during the years 1838–1848 (Hobsbawm 1996; Jones 1983; Cannadine 1998; Polanyi 2001; Butt 1973). All manifested the growing polarisation, heralding the appearance and emerging power of the massive working and socialist movements within the next few decades.

At this point, we should stress that the working classes’ disapproval and resistance did not focus only on the new economic conditions, but, essentially, on every single dimension these conditions brought about; that is, the new social structures, the new labour conditions, the new family structures and the new cultural milieu. To invoke Dickens’s hero in Hard Times: “[i]t was a fundamental principle of the Gradgrind philosophy that everything was to be paid for. Nobody was ever on any account to give anybody anything, or render anybody help without purchase. Gratitude was to be abolished, and the virtues springing from it were not to be. Every inch of the existence of mankind, from birth to death, was to be a bargain across a counter. And if we didn’t get to Heaven that way, it was not a politico-economical place, and we had no business there” (Dickens 2005: 308). In other words, the transition to a new form of society, which was identified “with the pursuit of profit, and forever renewed profit, by means of continuous, rational, capitalistic enterprise” (Weber 1992: xxxi–xxxii), and to a system of action diffused with a totally utilitarian and individualistic character,¹⁴ had a major impact upon the majority of the British population, especially, during the period of the so-called “Second Industrial Revolution”. Accordingly, the secularization and concomitant ideological hegemony of the Protestant values in people’s practices, the domination of the notion of “professional calling” and the moral value of labour (Weber 1992), the strict distinction between the working and the private sphere, the general restructure of labour conditions that were orbiting around the new forms of labour discipline and the new, more rational conception and more efficient use of working time (Thompson 1967), the general social, cultural and epistemological transmutations, literally transformed people’s bodies and people’s lives. Within this frame, the working class seemed to have only two options: either to compromise and attempt to adjust to the new historical conditions, or to fight and resist.

In 1848, the so-called “Spring of Nations” marked a new, quite different and, to an extent, more “peaceful” period in the history of European societies (Hobsbawm 1989, 1995; Polanyi 2001). The years that followed were a period of systematic, political and economic liberalism, and the world was becoming genuinely capitalistic.¹⁵ Within this frame, British economy confirmed what had been quite obvious during the eighteenth century; namely, the displacement of the, until then, powerful Dutch Republic and its own economic and commercial supremacy (Duplessis 1997). As Polanyi remarks, “[t]he nineteenth century, as cannot be overemphasized, was England’s century. The Industrial Revolution was an English event. Market economy, free trade, and the gold standard were English inventions” (Polanyi 2001: 32). Even by the end of the nineteenth century, the London Stock Exchange, founded in 1801, was widely viewed as “the hub of a global investment market” (Johnson 2010: 2).

In general, during the second half of the nineteenth century, the remarkable population growth was continuing, leading to a, without precedent, migratory flow,¹⁶ and to a sudden – from then on, continuous – decline in agriculture and its concomitant compliance with the rules of the world industrial economy (Woods 1992).¹⁷ Despite the huge impact of the “Long Depression”, beginning after the 1873 crash and running throughout the 1870s and 1880s – also known as the first truly international crisis of the capitalist system that did, however, concern the profits and not the production per se – economy continued to develop during the last quarter of the nineteenth century. It was clearly becoming more pluralistic and more competitive along with the development of modern nation-states. “Trust” and “management” constituted its major characteristics, the consumer goods market was being transformed and greatly expanded, the tertiary sector was rising and expanding as well, there were noted remarkable technological and scientific achievements, whereas the role of the state was becoming continuously more weighty. Under these circumstances, London was, without doubt, the city that starred. “The nineteenth century acknowledged London as the centre of things” (Porter 1994: 225); this was a fact that could not be very easily challenged.¹⁸ Britain’s national economy was based, to a great extent, upon London’s huge economic potentials through its imports and transportations, its networks of communication, its networks of wholesale and retail, its hospitals and institutions, its aura of cosmopolitanism and luxury. And it was the middle and upper social classes who were standing with self-reliance and pride in front of what they thought of as their own “accomplishments” and their own “achievements”.

Nonetheless, the sky was not cloudless. France turned out to be, once more, the political barometer of Europe. The 1871 Paris Commune, following the example of the 1789 French Revolution, had major consequences upon Britain – and Europe, in general – which, during the last quarter of the nineteenth century, entered into a period of mass democracy, leading, at first, to the expansion of the electors’ body.¹⁹ This development had two major effects. On the one hand, it led to the emergence and development of socialism as a major political movement.²⁰ On the other hand, it led to the emergence and development of nationalism, especially, through the involvement of the middle and lower social classes. Despite the fact that this period was mainly characterized by a constant pursuit for political stability, the 1880s were marked by social unrest and, especially, by a rising and intensifying flow of strikes during its last years (Cannadine 1998). For, once again, it was the upper social classes and the emergent middle classes who were mainly favoured by the economic and political conditions, and the fervent social mobility.²¹ On the contrary, in the capitalist metropolis, the working classes were scourged by overpopulation and congestion within the numerous slums to be found in almost every corner of the vast cities, by the growing criminality, by the dangerous defilement of water and air pollution, by the mass of epidemic diseases, by the capitalist exploitation of their own bodies.

Within the historical context of the above transformations, within a growing dissension about the, until then, solid certainties of nineteenth-century society and, at the same time, within the frame of the nineteenth-century illusions and peculiarities that even “belle époque” would, in a way, bolster and preserve, there was noted a general, conservative trend of the bourgeoisie. For, from now on, it would aim at both the safeguard and preservation of its power, and the control and management of every aspect of human activity and practice. In other words, there was noted a significant shift of the bourgeoisie itself from a “revolutionary class” to a “class in power”, focusing on consolidating conformity and uniformity within society, as well as on the simultaneous disciplining of every kind of “different” human action and behaviour, on the normalization of every single body (Grivas 1985). Within this frame, people suffering from neurological disorders, as well as madmen, those suffering from venereal diseases, mental defectives, alcoholics, in other words, every person who was thought of as “different”, “pathological” and, for this reason, “dangerous”, became the first targets of the ruling classes’ attempt to restore order. In this multidimensional procedure, nineteenth-century medicine dynamically came to the forefront, constituting an inseparable part of Victorian society and, at the same time, a decisive factor in the construction of its specific identity.

“Disease is a social development no less than the medicine that combats it” (Porter 1999: 15). Roy Porter’s phrase summarizes, to a great extent, our approach not only towards scientific medicine, but, especially, towards the notion of illness per se. In the Introduction, we presented some basic points concerning the ways scientific knowledge is constructed and disseminated. In this section, we are going to focus on scientific medicine’s development and consolidation in nineteenth-century England, as well as on its multilevel incidences and effects that marked Victorian society’s body politic.

The historical phenomenon known as the “Enlightenment” constituted a major rupture in the history of western societies, causing major transformation in the field of science, in general, and of medicine, in particular. Already, after the Cartesian “cogito ergo sum”, the subject’s autonomy and essence was being set in direct relation to his/her rational thought and understanding (ratio), and defined as a prime cognitive subject/object, while the mechanistic conception of the human body constituted the first alternative model to the Aristotelian and Galenic physiology that was prevailing until that time (Labisch 1992; De Renzi 2004). It was the transition from the “Ancien Régime” to the industrial society that proved to be the social, political and epistemological threshold for a new conception of people’s bodies, of people’s health, life and death.

In late eighteenth century, Thomas Robert Malthus (1766–1834) in his six-volume work An Essay on the Principle of Population (1798–1826) put forward the problem of the population’s rapid increase. To his view, human population tended to increase more rapidly than the resources that were available for its subsistence. Consequently, a significant part of the human population would always be condemned to famine and poverty. As Malthus himself highlighted, “[p]opulation, when unchecked, increases in a geometrical ratio. Subsistence increases only in an arithmetical ratio. […]. This natural inequality of the two powers of population and of production in the earth, and that great law of our nature which must constantly keep their effects equal, form the great difficulty that to me appears insurmountable in the way to the perfectibility of society” (Malthus 1798: 4–5).

According to Michel Foucault, it was exactly at the end of the eighteenth and in the nineteenth centuries, within the frame of the new necessities of the emergent capitalist mode of production, when the concept of the “population” emerged as the main interest of the power apparatus. In other words, it was during this period that one of the most significant phenomena in human history took place: human life was “seized” by power (Foucault 2003a). “Anatomo-politics of the human body” and “bio-politics of the population” were the two poles around which this power’s hold over life was orbiting; on the one hand, the study and control of every single dimension of the individual body, its disciplining, its optimization, the increase of its usefulness and productivity, and, on the other hand, the emergence of the population – that is, not only of the individual, but, especially, of the social body – as a political and economic problem (Foucault 1998). People’s fertility and reproduction, health and illness, mortality and death, their habits, every facet of their everyday life, were placed at the centre of a systematic and assiduous scientific discourse and practice. In this process, it was the nineteenth-century bourgeois state that undertook under its auspices the responsibility of its citizens’ health and proclaimed war against any kind of illness – physical, mental, even “social”. In fact, Foucault coined the term “governmentality” (“gouvernementalité”) to describe this historical procedure where man has become the object par excellence of disciplinary and regulatory mechanisms that rendered it possible for the human population to enter into the calculations and control of bio-power; “this bio-power was without question an indispensable element in the development of capitalism; […]. The adjustment of the accumulation of men to that of capital, the joining of the growth of human groups to the expansion of productive forces and the differential allocation of profit, were made possible in part by the exercise of bio-power in its many forms and modes of application. The investment of the body, its valorization, and the distributive management of its forces were at the time indispensable” (Foucault 1998: 140–141). To this direction, medicine was constituted as a distinct scientific field and its role and stance within the industrial society were thoroughly reformulated, while the concepts of health and hygiene were re-conceptualized. From now on, scientific medicine “[i]n the ordering of human existence it assumes a normative posture, which authorizes it not only to distribute advice as to healthy life, but also to dictate the standards for physical and moral relations of the individual and of the society in which he lives” (Foucault 2003b: 40).

Under these circumstances, medicine’s rationalization took place at the beginning of the nineteenth century, while, during the years 1860–1914, what one could call “orthodox” medicine became largely professional (Hardy 2000). These procedures put an end to the domination of “medical pluralism” and the concomitant mingling of magical, supernatural, religious and, at the same time, medical theories and practices in the explanation and treatment of the diseases that prevailed, at least, until the end of the seventeenth and the beginning of the eighteenth centuries (MacDonald 1981; Sawyer 1989). Scientific medicine was now divided into three sectors: the private, the “public” that was mainly maintained by charities, and the Poor Law sector (Lawrence 1994; Brunton 2004). These sectors provided to the majority of the English population access to a series of medical services, according to their social and economic status.²² At the same time, the invention of the classical techniques of clinical examination (inspection, palpation, percussion, auscultation), along with a series of new discoveries (Porter 1999; Jacyna 2004),²³ fostered the aforementioned trend towards the scientific conception and practice of medicine, transforming the human body into the primary target of the nascent medical gaze. Besides, the medical gaze “embraces more than is said by the word ‘gaze’ alone. […]. The medical gaze is now endowed with a plurisensorial structure. A gaze that touches, hears, and, moreover, not only by essence or necessity, sees” (Foucault 2003b: 202).

Without doubt, the new technological tools and, especially, the new conception of the disease as an entity localized in a definite part of the human body, led to the creation of new medical specialties, such as bacteriology, ophthalmology and orthopedics; “the nineteenth century brought specialization, bifurcation and fragmentation in medical research and practice” (Porter 1999: 527). Probably, the impressive consolidation of surgery had been the zenith of this major turn (Porter 1999; Schlich 1994, 2004).²⁴ Undoubtedly, it may be that the new techniques of anesthesia and antisepsis accelerated the acceptance of patients’ surgical treatment (Porter 1999; Ackerknecht 1982).²⁵ Nonetheless, even more significant were both the gradual abandonment of the, until then, dominant Hippocratic and Galenic holistic medicine, and the adoption of the new “localistic” approach of bodily organs and functions; according to Christopher Lawrence, “so great was the determination [of surgeons] to invade [the body] by the 1840s that, in retrospect, the invention of technologies to facilitate this invasion seems inevitable” (Schlich 2004: 80). This notion of localization would prove extremely significant in Jackson’s neurophysiology and epilepsy’s changing perception and identity.

In direct connection to the aforementioned, the hospital underwent major transformations and modifications during the nineteenth century. In contrast to most European countries, there were a very few hospitals in England due to the dissolutions of the monasteries, which were used also as therapeutic centres, by Henry VIII, between the years 1536–1541. For this reason, it was the eighteenth century and, especially, the 1740s that witnessed a wave of new hospitals that took off during the nineteenth century. As a result, in 1861, there were in England and Wales about 14,800 beds in voluntary hospitals and about 29,500 in 1891, while in the sector administered by the Poor Law, there were 50,000 beds in 1861 and 83,820 in 1891 (Woodward 1984). Accordingly, there were in London thirty-nine dispensaries, fourteen general and sixty-six special hospitals, in 1861 (Marland 2004; Lane 2001).²⁶ So, the hospital was gradually consolidating itself within the industrialized English society, being transformed “from a charitable refuge for the sick poor into an all-purpose medical institution” (Porter 1999: 380).

More importantly, the establishment of the hospitals was followed by their gradual specialization; a procedure that had begun during the last quarter of the eighteenth century and was intensified during the nineteenth century, primarily, due to the aforementioned multiplication of medical specialties (Granshaw 1989). The beginning of this process can be detected in the initiatives of some physicians, who, being excluded from the higher ranks of the established medical profession, attempted to promote their status by founding, at first, outpatient dispensaries. The dominant model for the nineteenth-century special hospital was Moorfields, which was set up, in 1805, as the London Dispensary for the Relief of the Poor Afflicted with Ear and Eye Diseases and which was followed by the foundation of the Royal Hospital for Diseases of the Chest (1814), the Royal Ear Hospital (1816) and the St. Mark’s Hospital for Cancer (1835) (Granshaw 1989; Turner 1995). However, we should stress that the reactions of the elite physicians towards the foundation of specialized hospitals were rather harsh, with the exception of those hospitals that served the needs of those patients who were, as a rule, excluded from general hospitals – in particular, those suffering from epilepsy, incurable diseases and venereal diseases, mentally defectives, pregnant women, etc. As we are going to see in the next chapter, the case of the National Hospital for the Paralysed and Epileptic was included in these exceptions. Of course, within the frame of hospital practice in either a general or a specialized hospital, the notion of the “patient” underwent a major alteration, as he/she was being transfigured – either alive, or even dead – into a “case”; that is, into an object of continuous medical surveillance, systematic record and scientific knowledge.

The above transformations had a major impact upon the role and status of those who practised medicine, as well as upon their relations, disputes and contentions. Throughout the nineteenth century, medicine began gradually to achieve ground and prestige, in relation not only to its past image, but also to the majority of the other “respectful” professions. This process kept step with the simultaneous emergence of an active middle class that defended passionately the fundamental importance of the individual’s personal value and hard work, declaring fervently the moral and political significance of the construction of an absolutely meritocratic society. The emergence of Harley Street as the consultants’ quarter in London’s West End marked the consolidation of an inner circle of well-respected and well-connected consultants in Victorian society (Porter 1999).²⁷ Consequently, the competition between the various groups of medical professionals was harsh and sometimes ruthless. Besides, already from 1779, when the first official ‘Medical Registers’ were issued, every patient could choose a practitioner and practitioners could contact each other (Woodward 1984; Lane 2001).²⁸ Thus, the disputes and contentions between the various groups of medical specialists constituted an inseparable part of their reality. The relations between the so-called “general practitioners” and the smaller group of elite practitioners, who dominated in the hospitals, were rather tense; one of the most common causes of their squabbles and frictions was the issue of payment (Brunton 2004). Equally tense were the relationships between physicians and surgeons, especially, in reference to the latter’s status and rank in the hierarchy of the established medical profession; the fierce competition between them began to die away in late nineteenth century (Schlich 2004).²⁹ Nonetheless, the status of the medical practitioners was continuously elevating, indicating the centrality of scientific medicine in the maintenance of health and, consequently, in the disciplining and normalization of the body politic, and the orderly operation of Victorian society.