Date of Award

Spring 2019

Project Type


Program or Major


Degree Name

Doctor of Philosophy

First Advisor

James Krasner

Second Advisor

Robin Hackett

Third Advisor

Brigitte Bailey





by Elizabeth Sheckler

University of New Hampshire

May 2019

The Victorians wrote extensively about the changes in medical practice between 1800

and 1910, both in public discourse and through their fiction. As a result, Victorian scholarship

often includes medicine. While approaches are varied, they are typically either concerned with

diseases, character models (like doctors), or medical interventions alongside other public

institutions (public health).

Scholars in interdisciplinary fields as well as in Victorian literature have written on medicine in the nineteenth century, including both historiographies on topics ranging from skin to pain, as well as microstudies interested in specific time periods, practitioners, or authors. The field is rich with interest in the ways medicine defined the Victorian world, and in recent years, many of these works reach outward to our present moment.

Studies of medicine and Victorian literature are generally concerned with events and people, not medical spaces, like hospitals. My dissertation examines sanitationism, a theory of disease wherein illness was generated from environmental causes. In sanitationism, medical spaces are the keystones of practice, and so by investigating this theory of disease, my project also examines those spaces in which medicine was practiced from 1830-1890. Sanitationism has largely been neglected in Victorian and history of medicine scholarship, but during the nineteenth century, the theory deeply impacted the Victorian worldview, and their writing.

Utilizing novels, nonfiction narratives, and primary sources on medicine and architecture from the period, supplemented by both Victorian and interdisciplinary scholarship, I explore four types of Victorian medical spaces to unpack the concept of sanitationism and its manifestations in Victorian writing. I deploy an interdisciplinary lens combining spatial power narratives, historicism, gender, and class theories as the foundation for my analyses.

My study traces the impact of sanitationism as formative of Victorian self-perception and impacting social hierarchies, especially the deployment of women as healers beyond the home. During sanitationism’s rise in chapters one and two, women in these narratives find themselves more influential and empowered in medical spaces, whereas during its decline, they similarly find their influence restricted, and eventually obliviated.

In conclusion, understanding sanitationism generates insight regarding the Victorian social world. Furthermore, sanitationism’s synergy between medicine, public policy, architecture, and social values like gender relations, indicates how deeply underpinning beliefs about disease can affect human behavior and interaction. By presenting these analyses of sanitationism in a range of Victorian works, my dissertation encourages future scholars to

consider the interplay of disease, spaces, morality, and gender together, which enriches both our studies of literature, as well as our understanding of interdisciplinarity. Lastly, my work

encourages us to think critically about the spaces where medicine is performed, and how such

spaces might impact outcomes, either in the nineteenth century, or the twenty-first.