Galdós and Medicine
Galdós acquired his medical knowledge at a time of great changes: anaesthesia and antisepsis were developed, and the germs responsible for many human diseases identified. French medicine was especially influential, though increasing international exchange resulted in new ideas also being adopted from England, Germany and Italy. The author of this study analyses Galdós’s network of medical contacts, together with some of the sources available to them. Subjects such as epidemic disease, madness and children’s diseases are examined and the light they throw upon the medicine of the time is discussed. The concluding chapter of the book assesses the significance of Galdós’s depictions of disease and of doctors.
Table Of Contents
- About the author
- About the book
- This eBook can be cited
- Chapter 1: Doctors and Medicine in Galdós’s Madrid
- Chapter 2: Epidemics: Cholera, Influenza and Smallpox
- Chapter 3: Endemic Diseases: Tuberculosis, Syphilis and Angina
- Chapter 4: Alcoholism
- Chapter 5: Madness
- Chapter 6: Eye Disease and Blindness
- Chapter 7: Childhood Diseases
- Chapter 8: Conclusions
- Series index
I should like to acknowledge with thanks the help and interest of Rhian Davis with certain sections of this book, together with Susan Irwin and Jesús Terrón. My warm thanks are due to Professor Henry French of the History Department of the University of Exeter for his support in making the facilities of the University available to me. They have been invaluable, as has been the help of Aeronwen Cole, university librarian. An enormous debt is due to my wife, Becky, for her patient help in checking the typescripts and for her forbearance in listening to far more than she ever wanted to know about B.P.G. ← ix | x →
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Doctors and Medicine in Galdós’s Madrid
In 1889, Galdós wrote a prologue for a collection of stories about childhood by his close friend, the paediatrician Manuel Tolosa Latour (1857–1919). In it he compares their loves for medicine and for literature: “Certainly, you have more of the author about you than I do the physician; but your love of letters is no greater than the passion inspired in me by the noble science that you practise.”1 In this modest confession, he accounts for one of the features of his writing that distinguishes him from any other author of his time: a fascination for, and knowledge of, medicine that enabled him to describe in detail some of the most fearsome diseases of his day. Contemporary authors writing Naturalist-Realist fiction such as Leopoldo Alas (Clarin), Emilia Pardo Bazán and José Pereda included doctors and disease in their writings, but no one of his generation portrayed them with the detail and frequency that appear in the work of Galdós.2
Galdós was indefatigable in the depth and thoroughness with which he researched fields of knowledge for the backgrounds of his novels. Such ← 1 | 2 → detail is apparent in his descriptions of the financial speculation that occurs in Lo prohibido, the evolution of the Madrid textile trade at the beginning of Fortunata y Jacinta, and the world of fashionable ladies’ attire that forms such an important element in La de Bringas. Among his contemporaries, Galdós impressed his friend and fellow novelist, Alas, who referred to him as, “curious about every type of knowledge, capable of penetrating the depths of many of them, if he determined that it was important to him.”3 Chonon Berkowitz later wrote that he used every type of resource to obtain the information he wanted, “he lost no opportunity to document thoroughly all the material he needed for his books, taking advantage of public libraries, private collections and archives, corresponding with people who could be useful to him, and consulting those who he used to call ‘living archives’ in the conference room of Congress.”4 Unlike the specialized fields of finance and fashion, what is particularly striking about Galdós’s use of medical detail is the frequency with which it appears in his novels, both in major and minor characters. Medical oddities are apt to arise in the latter as a part of their natures, a feature of Galdós’s technique of characterization.
This great flair for clinical description was recognized in the author’s own time. In 1882, even before Galdós had written many of his most memorable depictions of disease, Benito Avilés, the editor of La higiene, wrote in an editorial celebrating the banquet held in the author’s honour, “By virtue of his ability, on a par with being the leading Spanish novelist, Galdós is a great doctor. We have not seen, nor are aware of, so perfect a description of the horrors of croup [diphtheria] as he furnishes in La familia de León Roch; no one has described as he does the anguished scene of the death of a child.”5 ← 2 | 3 →
In the following year, under the pen name of El Doctor Fausto, Tolosa Latour wrote an ample tribute to Galdós in La Época, emphasizing not only Galdós’s wide scientific and medical knowledge but also his popularity among readers of the medical profession:
He has affection for medicine and doctors. […] Augusto Miquis, the distinguished physician of la Desheredada, is a portrait of body and soul; the scenes of croup in Leon Rock (sic) and the operation of Teodoro Golfín, the ophthalmic surgeon, are studied with exquisite care and described in a surprising manner; and finally there are not a few well-known doctors among his most assiduous and enthusiastic readers …6
At Galdós’s reception into the Real Academia Española in 1897, his long-term friend and ideological opponent Marcelino Menéndez Pelayo replied to his acceptance speech with a long account of Galdós’s literary achievements. He paid particular attention to Galdós’s ability to portray abnormal mental states, likening him to Charles Dickens, “who he resembles […] in the richness of detail seen as if with a microscope […] in the portrayal of unusual states of consciousness, the mad, sleep-walkers, mystics, visionaries, and fanatics of every type.”7 ← 3 | 4 →
After Galdós’s death in 1920, assessments of the medical portraits in his novels soon followed. Bravo Moreno in 1923 reviewed the portrayal of insanity in Galdós’s characters according to pre-Freudian conceptions of mental disease, while Walton refered to Freudian ideas in 1927 when he discusses Ángel Guerra and Maximiliano Rubín (Psicología 177, 190), returning to a fuller Freudian assessment in 1948 (Galdós 11–12). Garma (1958), Elliott and Kerscheville (1940), and Ullman and Allison (1974) are also notable for their efforts t0 portray Galdós as a Freudian avant la lettre. Iglesias (2006) classifies Maximiliano Rubín’s mental illness according to more recent diagnostic categories. Several characters in Fortunata y Jacinta are studied by Larsen (1996, 1998, 2006), while Gordon essays the medical background of La desheredada. A broader examination of the background of medicine as it appears in the Realist novel is to be found in the work of Pérez Bautista (1972), Granjel and López Piñero (1970–71), the latter also with García Ballester and Faus Sevilla (1964). Dissertations that have appeared on medicine and physicians in Galdós include those of Boix Martínez (1994), García Lisbona (1992), Smith (1977), Vozmediano Hidalgo (1981), and Willey (1964).
Unsurprisingly the majority of studies of medicine in Galdós have been made from a variety of literary perspectives, the few exceptions including Barbón-García et al., and Álvaro and Martín del Burgo. There appear to be few studies that have looked in depth at the ideas current in medicine at the time that Galdós wrote.8 Similarly absent is a study of specific texts from which he may have drawn, directly or indirectly, in his depictions of disease in his characters. This may relate to the apparent paucity among students of Galdós of those with medical training and an interest in nineteenth-century ← 4 | 5 → medicine. Taking this into account and bearing in mind my own training in medicine, this study has been undertaken in order to draw attention to this neglected aspect of Galdós’s intellectual background. For it is clear that Galdós took medicine very seriously, and at least one writer on medicine in the novels goes as far as to assert that he would really have liked to have been a doctor, and that his passion for medicine, “was almost the consolation of a frustrated vocation: his [vocation] for medicine.”9
Galdós’s realistic descriptions of disease can invite medical analysis as if they were clinical pictures, and Ribbans expresses an ambivalent view as to how this temptation should be addressed. On the one hand he advises, “Care must be exercised in treating characters as medical case-histories and in particular in speculating beyond what is given in the text,” while on the other he admits that, “At the same time medical evidence can be very useful in elucidating, verifying or assessing the information provided.”10 The essence of Ribbans’ counsel revolves about the information provided in Galdós’s text, attentive study of which frequently throws additional light upon the conditions he describes. This is especially true if his text is approached with some knowledge of the medical background of his time. Much can be elucidated from the information he provides, as the following chapters illustrate.
The changes in medicine that took place in Galdós’s lifetime were enormous. At his birth in 1843, the role of micro-organisms in human disease had barely been recognized and laboratory medicine was in its infancy. By the time of his death in 1920, medicine had entered a recognizably modern era following the discovery of X-rays and viruses, and the development of blood transfusion and the electrocardiogram. The organisms responsible for the great epidemic and endemic diseases: tuberculosis, typhoid, whooping cough, tetanus, diphtheria, cholera, leprosy and syphilis were all discovered in the course of his lifetime. Galdós was aged twenty-four when Lister developed the technique of surgical antisepsis with carbolic ← 5 | 6 → acid that later evolved into the modern practice of asepsis. Lister’s work greatly increased the scope and safety of surgery, especially in conjunction with inhalational anaesthesia adopted from the 1840s onwards. Galdós was a personal friend of several Madrid surgeons who were prominent in introducing these innovations in Spain.11 He was well-placed to learn about these medical advances.
Some medical discoveries may take years, if not decades, to be accepted in medical practice. This was especially true in Spain where almost all the major advances in medicine of Galdós’s time were first developed outside the country.12 The Guerra de Independencia,13 three Carlist civil wars and the Revolution of 1868 left the country ill-equipped to invest in scientific research.14 Added to this, the tradition of xenophobic ultra-conservatism ← 6 | 7 → allied with the Catholic Church militated against Spanish scientists’ attempts to adopt or develop new ideas.15 Holding views linked with the theory of evolution after the publication of Darwin’s On the Origin of Species in 1859, could be considered as grounds for dismissal as late as the 1890s. In Galdos’s time, Madrid suffered more from diseases resulting from poor sanitation than any other Western European city. While new sanitary measures had been introduced from England in 1834 by Mateo Seoane, on his return after the death of Ferdinand VII, they had not kept pace with with the growth of cities.16 Major movement from rural communities to cities in search of work resulted in population growth that far out-stripped facilities for the provision of clean water, and adequate disposal of waste. In comparison with cities abroad, and with Barcelona and Bilbao in Spain, Madrid also lagged far behind in industrial development with the result that most newcomers were unable to find regular employment.17 This, in ← 7 | 8 → turn, led to gross overcrowding in fearfully unhealthy suburbs, barrios, from which disease, prostitution and crime threatened to extend to the rest of the capital.
The consequences for the health of most madrileños were dire. Mortality statistics compiled from the middle of the century onwards showed the highest infant mortality rates in any Western European city, with the highest mortality for those of adult years.18 Any newcomer to Madrid, like Galdós coming from the relatively salubrious port city of Las Palmas, cannot but have been very aware of the plight of his fellow citizens. As a journalist with zeal to explore Madrid society, Galdós must have witnessed much of its poverty and disease; he observed firsthand the major outbreaks of cholera that spread to the capital in 1865 and 1884–85.
Struggling with Madrid’s inadequate health statistics, Francisco Méndez Álvaro, president of the Sociedad Española de Higiene founded in 1882, drew upon figures compiled in Berlin, London and Paris as he and other members of the new society attempted to account for the mortality rates seen in Madrid in that year. The rate in 1882 was twice that of English and French capitals (Actividad 9) with a marked increase since previous years in deaths from smallpox, measles, diphtheria, and tuberculosis and, above all, from acute respiratory infections (5). Members of the Society suggested that the high altitude and harsh winter winds of the capital contributed to this mortality, in association with the permeable, porous soil that was thought to favour the development of epidemics. They highlight the inadequacy of the city’s system of drains for removing factory and ← 8 | 9 → private waste, which had not kept pace with the city’s population.19 The group refers to what they regard as the model Public Health Act in England of 1875 and asks rhetorically how long it will be before similarly mandated measures for community health infrastructure are seen in Madrid (20). The editor of La higiene, Benito Avilés, associates a “fever” of overbuilding with the accompanying need to move large quantities of earth contaminated by open latrines, which he relates to the “terrifying mortality,” espantosa mortalidad, of the years between 1880 and 1891, particularly due to typhoid fever. He also notes the deficient system of sewers of Madrid, and the inefficiency and irregularity of their inspection (Higiene 826). Hygienists were even more discouraged by the lack of significant progress in the decades between 1880 and 1900. Physicians of the city’s Beneficencia Municipal, such as Fatás y Montes, in his 1903 analysis of the causes of infant mortality, high in comparison with other cities, makes the same complaints about governmental indifference to public health that had been aired twenty years earlier:
Associated with the increased mortality as a result of infectious diseases [are] the bad organization of Madrid’s sanitary system, the failure to fulfil the regulations designed to prevent [those diseases], the apathy of authorities in undertaking reforms of any kind that fall within the sphere of public health and the failure [of individuals] to observe the norms of personal hygiene.20
Echoing the deficiencies of the sanitary corps of the medical profession, Ángel Pulido, by 1902 Director General for Public Health, sternly rebuked ← 9 | 10 → the nation’s colleges of medicine and pharmacy for the shortcomings of public health physicians deploring “the backward state in which our national, provincial and municipal sanitary doctors find themselves, and the little understanding that the classes of the nation’s society have of so important a branch of public life.”21
A root cause appears to have been the reluctance of successive governments to delegate administration of public health and sanitation to the medical profession, starving them of both money and the necessary impetus for reform. Comenge writes in 1914:
The power awarded to political bosses and mayors, their subordination of sanitary committees and inspectors, who only had responsabilities and difficulties, and, to crown it all, the weight of political alliances in decisions of [public] hygiene, provide eloquent explanations for the fruitlessness of the work of sanitary legislation. And this sterility was not restricted to the generations of the mid-century, it continued and continues at present in the absence of coherence and authority in public health administration and the gulf between the community and public health. We descend into a sad and shameful situation, not only in the face of exotic infectous diseases, but in the struggle against preventable illnesses (smallpox) and inhuman violations, the adulteration of foodstuffs and insanitary housing, for example.22
- X, 230
- ISBN (PDF)
- ISBN (ePUB)
- ISBN (MOBI)
- ISBN (Softcover)
- Publication date
- 2015 (March)
- Galdos Realism Medicine in Literature
- Oxford, Bern, Berlin, Bruxelles, Frankfurt am Main, New York, Wien, 2015. X, 230 pp.