Janis McLarren Caldwell compares Charlotte Brontë’s writing about experiences of imaginative transport (in the Roe Head Journal, which sustained engagement with the Angria of her earlier juvenilia, and in Jane Eyre) with Victorian scientific writing about the imagination. The work of early psychologists increasingly described creative imagination not as Romantic transcendence, but as a function of the automatic mind. For Caldwell, the discontinuity experienced by Brontë between creative unconscious and conscious states may be related to her frequent mature pattern of presenting Romantic interludes only to ironise or deflate them. Caldwell shows how Brontë’s early writings reserved her most exalted language for the experiences of imagining. Drawing upon Elaine Scarry’s notion of vivacity, Caldwell explores how Brontë’s work is placed in relation to pictorialist accounts of mental imaging. Charlotte Brontë, while influenced by materialist thought, rejected the wholesale erasure of the soul. While Brontë was attuned to ideas about embodiment and scientific accounts of the mind, she also employed a Scriptural language of body and soul. As Caldwell’s chapter shows, Charlotte Brontë’s introspective accounts of creativity are valuable for our contemporary neurological understandings of verbal and visual cognition, and continued Western philosophical investigations of the mind/body problem.

Like so many of his time, Charles Dickens was intimately acquainted with the effects of illness and disease. Small for his age and afflicted with spasms of renal colic, young Charles was no stranger to physical pain. By the time he was 12, he had witnessed the close association of disease and poverty. The squalor of the Marshalsea prison, in which his father was detained for debt, and the illnesses of its inmates, impressed him with a lasting horror. As an adult, Dickens was shocked by the mysterious sudden sickness and death of his 17-year-old sister-in-law Mary Hogarth, who died in his arms. He nursed several of his ten children through febrile illnesses, probably both typhus and cholera, and lost one infant daughter. His favourite sister, Fanny, died an agonised death of consumption, or what we now call pulmonary tuberculosis. Later in life Dickens suffered from high blood pressure and cerebral vascular disease. He died at the age of 58 of a cerebral haemorrhage.

This long list of illnesses was not untypical for a Victorian family. Members of all socio-economic classes were well acquainted with consumption, which was endemic throughout Britain, causing a chronic, often bloody cough, intermittent fever, a long wasting illness and early death. Cholera epidemics swept the country in 1831/2, 1848/9 and again in 1853/4. A particularly terrifying illness, cholera provoked violent diarrhoea, rapid dehydration and circulatory collapse, killing about half of its victims – often within days.

On first consideration, Emily Brontë may seem out of step with the medical thinking of the period. She was personally averse to any form of medical treatment, and during her final illness she rebuffed her sisters' attempts to send for a doctor. Charlotte, nearly desperate, wrote that Emily “has refused medicine, rejected medical advice; no reasoning, no entreaty, has availed to induce her to see a physician.” Although Emily never explained her aversion, we may see some clue to it in her portrayal of a country surgeon in Wuthering Heights. Kenneth is a morose, pessimistic visitor at the deathbed, who refuses hope to Frances and family, pronouncing, according to a servant girl, that “mississ must go … I heard him tell Mr. Hindley … she'll be dead before winter” (WH, 49). When Lockwood gets a cold, he complains of Kenneth's “terrible intimation” that “I need not expect to be out of doors till spring!” (WH, 70). Nelly tells us that doom-and-gloom Kenneth, called to Catherine in her grief after Heathcliff's departure, makes swift work of his attendance:

One of the most striking differences between the work of Emily Brontë and that of her sister Charlotte is found in their representations of childhood. For Emily, the natural child is “half-savage and hardy and free,” rambling on the moors, breathing the dry, salubrious air of the high ground. For Charlotte, the child is plagued by privation and ill health, rarely escaping the unhealthy miasmas of symbolic prisons like Lowood. In part, this can be explained by the two girls' differing experiences at the Cowan Bridge School for Clergymen's Daughters, the institution that inspired Lowood. The healthy young Emily was the “pet” of the school and probably too young to be aware of the institutional neglect that hastened their elder sister Maria's death. But this experience marked Charlotte so completely as to mar forever her memories of childhood, despite her appreciation of its imaginative intensity and personal attachments. One might observe that if Wuthering Heights is a novel of regression, Charlotte Brontë's novels are about the struggle toward maturation. Charlotte's “Farewell to Angria” closes her apprenticeship to childhood romance and opens arguably one of the most important chapters in the development of the bildungsroman for the British tradition.

Perhaps because of her early acquaintance with privation and disease, Charlotte demonstrated less faith in the kind of natural health promoted by domestic medical texts, and exhibited less aversion to doctors and their interventions, than did Emily.

If Frankenstein articulates the frustrations of an apparent mismatch between body and mind, Sartor Resartus promotes a productive dialectic between these two conflicting ways of encountering the world. Carlyle broadens the terms of the specifically human body/soul dichotomy into a dualism of the entire cosmos, and translates those terms into two ways of viewing the world: the natural and supernatural respectively. For Carlyle, the natural perspective alternately conceals and reveals the supernatural, which in turn continually makes and remakes the natural. Although the natural and supernatural points of view are frequently at odds, they neither cancel one another out nor tie one another up in an endless stalemate. Rather, a dialectical conversation between the two modes of explanation produces an organic, continually developing body which gives shape and tangibility to the inner, living experience of the holy. The tailor is retailored; makers are themselves remade. In comparison to Mary Shelley's vision in Frankenstein, Carlyle's practitioner of sympathy not only tolerates the conflict between inner and outer points of view, but also finds in their interaction the source of transformation and renewed meaning.

This chapter will argue that Thomas Carlyle, in Sartor Resartus, and Richard Owen, in his anatomical writings, both employ two ways of reading one infinite world. Both of them accept – even revel in – disjunctions between prophetic and natural ways of knowing, using those differences to reinvigorate some of the outdated metaphors of natural theology.

Perhaps because the tale is familiar, we often forget how odd it is that Frankenstein began as an entry in a ghost-story contest. The monster, after all, is an unlikely candidate for a ghost – constructed by a scientist out of dead body parts into a grossly oversized, undeniably living organism. How did a hyper-physical creature come to stand in for a ghost? As Mary Shelley recalls in her 1831 preface, her “unbidden” imagination worked with the diverse materials at hand – which by chance included transcendental fantasy and reports of scientific experiment. A “wet, uncongenial summer,” so the story goes, confined her party – including her husband Percy, Lord Byron, and his doctor, John Polidori – to the house. They entertained one another by reading aloud German ghost stories until Byron proposed that they “each write a ghost story.” A few nights later, Mary was racking her brain for an idea when she listened in on a discussion between her husband and Lord Byron:

At first blush, Charles Darwin may not seem to have much to do with Romantic medicine, or with the narrative and interpretive practices I have been discussing. But in fact, Darwin's thought arises directly out of Romantic medicine, embodying the fullest and, paradoxically, the final expression of Romantic materialism.

Charles Darwin came from a medical family. His grandfather Erasmus Darwin was a renowned physician, as well as a poet. Historian Desmond King-Hele writes,

Following in his father's footsteps, Erasmus Darwin's son Robert also became a physician of legendary skill, amassing a large fortune from his practice and achieving a high status in the town of Shrewsbury.

Robert's second son Charles – that is, the Charles Darwin who wrote The Origin of Species – was from birth destined for medicine as well. He was named after his uncle, who, as a promising young medical student, cut his finger during the dissection of a cadaver and died of the ensuing infection. Young Charles was initially eager to take up the family profession.

One of the most significant developments of Romantic medicine was the diagnostic practice of weighing two different kinds of evidence: the patient's narrative and the physical exam. Before the nineteenth century, doctors relied for diagnosis primarily on the patient's report of his or her illness – so much so, that it was not uncommon to treat patients via correspondence. Before the clinical era, physical examination was limited to noting the quality of the pulse (not counting it) and occasionally the examination of bodily fluids. Only in the early nineteenth century did doctors begin to practice thorough palpation, auscultation (listening to body sounds), and measuring various bodily signs (pulse, breathing, temperature). With the rise of clinical medicine, as disease was correlated with local pathology through the post-mortem dissection, doctors began to try to elicit evidence of localized disease in the living patient. Physical signs became as telling as the patient's story, but in a completely different way.

Historians of medicine, especially Nicholas Jewson and Roy Porter, have noted this changing balance of power, from a client-dominated doctor/patient encounter in the early eighteenth century to the rise of medical power in the nineteenth. Building on their research, Mary Fissell tracks the “disappearance of the patient's narrative” in British hospital medicine in the late eighteenth century. Comparing medical case reports with patients' autobiographical accounts, Fissell finds the patient's experience to be increasingly sidelined by clinical reporting. Fissell writes, “The patient's narrative was replaced by physical diagnosis and post-mortem dissection. The body, the disease, became the focus of the medical gaze, not the patient's version of illness.”

This book is about a remarkable episode in the history of literature and of medicine, in which several influential literary and medical writers were allied in one project, that of negotiating between two distinctly different ways of knowing – between, that is, personal experience and scientific knowledge of the natural world. Although we have come to regard “clinical” and “Romantic” as oppositional terms, clinical medicine emerged from the same culture that nourished Romantic literature. In the first half of the nineteenth century, a number of leading doctors and writers cultivated a form of double vision which I will call “Romantic materialism”: Romantic because they were concerned with consciousness and self-expression, and materialist because they placed a particularly high value on what natural philosophy was telling them about the material world.

My argument, in short, is that Romantic materialists, as inheritors of the conceptual structure of natural theology, read the world through “two books”: the Book of Nature and the Book of Scripture. But, unlike traditional natural theologians, Romantic materialists accepted disjunctions between the two ways of knowing and called for an interpretive method which tacked back and forth between physical evidence and inner, imaginative understanding. This dialectical hermeneutic yielded innovations in both medical diagnostics and literary representation. Clinical practitioners developed the two-part history and physical exam, tolerating the tensions between the patient's narrative and the evidence of the body.