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This essay examines the prevalence of a romantic discourse (e.g., associated with the genre of romance) in nineteenth-century British treatises on diseases of the heart. The nineteenth century brought remarkable changes to cardiac medicine, from the stethoscope to the sphygmograph, rendering medical practice increasingly clinical. However, case histories of cardiac disorders from this period maintain a surprising frequency of three affective elements: sensationalism (exaggerated, dramatic, and shocking events and language), sentimentalism (pathos and melancholy), and imagined experience, where the narrator projects himself imaginatively into the lived experience of his subject. British cardiac texts during these professionalizing decades repeatedly use the ambiguous term “distress” to describe the symptoms of heart disorders but also the observer’s subjective response to the patient’s evident suffering. These “distressing” texts demonstrate how nineteenth-century British physicians narrativized their sympathy during a period we usually associate with the distancing of the patient-physician relationship.

IN 1856, WHEN MANY VICTORIAN PHYSICIANS WERE STRUGGLING TO DEFINE A MODEL OF CLINICAL MEDICINE, the reviewer of one collection of case histories voiced his dismay at the physician-author's preference for “dreadful incidents” and “cases exceptional and strange” (“Works” 473). Indeed, although physicians of the clinical era did not disguise their efforts to achieve a new kind of discourse, productive of a “realist” vision, few acknowledge how often the “clinical” case history of the nineteenth century also shares the romantic discourse of the Gothic, especially its interest in the supernatural and the unexplainable and its narrative aim of arousing suspense, horror, and astonishment in the reader. Literary critics have also focused primarily on the association of medical narrative with a realist literary discourse. Nineteenth-century physicians did campaign for the formal, objective, and professional clinical discourse that serves as their contribution to a realist aesthetic, in the process explicitly rejecting eighteenth-century medicine's fascination with “the curious” and its subterranean affiliation with the unknown, the unexplainable, and the subjective. But, as I show in this article, a discourse of “the curious,” allied with a Gothic literary aesthetic, stubbornly remained a critical element of many case histories, though it often presented under the mask of the more acceptable term, “interesting.” The discourse of Gothic romance in the case history provides a narrative frame that, unlike the essentially realist clinical discourse, could make sense of the physician's curious gaze, which had become nearly unrecognizable as a specifically medical vision. Indeed, a “curious” medical discourse haunts even case histories of the high clinical era, late in the century; and it energizes the nineteenth-century Gothic novel. Samuel Warren's novelPassages from the Diary of a Late Physician–deplored in the quotation above–illuminates this tradition of “Gothic medicine” as it plays out in the nineteenth-century novel. This tradition, I argue, provides the novel with a powerful model of cultural contamination and conflict in its yoking of disparate discourses. Gothic medicine demonstrates the importance of clinical medicine to literary romance, and it cannot help but reveal the ghost of “the curious” in the clinic.

Meegan Kennedy, “‘A True Prophet’? Speculation in Victorian Sensory Physiology and George Eliot’s ‘The Lifted Veil’” (pp. 369–403) George Eliot’s novella “The Lifted Veil” (1859) is often considered an outlier in Eliot’s realist corpus, perhaps due to its focus on controversial theories of mind (phrenology, animal magnetism) and physical medicine (blood transfusion, human experiment, reanimation). The story draws on a tradition of Gothic medicine long recognized in the romantic novel but less acknowledged in histories of clinical medicine. As this essay shows, however, mid-Victorian clinicians and researchers accepted speculative cases of hyperaesthesia, prevision, and telepathy as a path for skeptical neurological inquiry. The textbooks of physicians like John Hughes Bennett, William Carpenter, John Elliotson, Henry Holland, and Forbes Winslow codified a range of sensational phenomena, circulating cases like Latimer’s and considering both natural and supernatural explanations for them. The events in “The Lifted Veil” are thus more realistic than they may appear; and the story extends rather than interrupts the trace of science in Eliot’s early fiction. In Latimer’s story, Eliot plays with the boundaries of Victorian physiology, neurology, and cardiology and expands our view of what both Victorian science and realism accommodate. “The Lifted Veil” performs and invites the same dual movement that mid-Victorian scientists were developing, a two-step of speculation and skepticism. As in Eliot’s other work, the analogy with scientific inquiry grounds the story’s moral, aesthetic, and epistemological concerns about human knowledge. Finally, these oddities of Victorian nerve physiology paradoxically allow Eliot to make a familiar realist argument, for this sensational story celebrates ordinary life as rare and valuable.