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Imagining Public Health in the Early 19th Century

  • Julia M. Wright

Today, a significant portion of the global population has ready access to vaccines, clean water, and universal healthcare. COVID-19 has, in part, been such a shock because many of us, especially in wealthy Western countries, are not used to being collectively threatened by serious diseases that spread and act quickly.

Not so long ago, we would have lived much more dangerous lives. In Britain, Edward Jenner’s scientific validation of smallpox vaccination in the 1790s helped begin to turn the tide against one deadly disease. But smallpox wasn’t their only problem. A full list of contagious diseases that were often at epidemic or pandemic levels in Europe before 1900 would be a long one and include influenza, measles, scarlet fever, and typhus. Literature of the time not only represents these diseases, but also reflects on the response to them.

In 1789, Olaudah Equiano published his Interesting Narrative, based on his experiences of enslavement and his life after. It was a bestseller in the terms of the time, and contributed to Equiano’s significant influence on British opposition to slavery and particularly the transatlantic slave trade. But Equiano’s extensive cross-cultural and maritime experience also shape the representation of health in the Narrative. Equiano is “amazed” to see people in England “eating with unwashe[d] hands” (43), for instance. While slave ships are “pestilential” (35), other trading ships are more careful about contagious diseases: “The plague broke out while we were in Smyrna; and we stopped taking goods into the ship till it was over” (126).

In Frankenstein (1818), Mary Wollstonecraft Shelley’s first novel, the scientific breakthrough of creating a human life gets the most attention. But passing references to epidemic diseases are part of the novel’s recognition of the precarity of life. For instance, Frankenstein’s mother dies of scarlet fever after breaking quarantine because she wants to visit a sick child (72). Two other characters are unjustly imprisoned in a “noisome dungeon” (140)—“noisome” has a history of being used in connection to typhus, also called “jail fever.”1

In a later novel, The Last Man (1826), Shelley depicts a pandemic sweeping across Europe at the end of the 21st century. Her futuristic England has achieved democracy and some technological advances, but is otherwise largely indistinguishable from England around 1800. Inequality, poverty, and other social ills persist. In a brief section of the novel, Shelley suggests a better path forward. A survivor of a previous outbreak, an elderly woman named Martha, helps her village weather the pandemic:

She entered the cottages of the sick; she relieved their wants with her own hand; she betrayed no fear, and inspired all who saw her with some portion of her own native courage. She attended the markets—she insisted upon being supplied with food for those who were too poor to purchase it. She shewed them how the well-being of each included the prosperity of all.

Mary Shelley, The Last Man, 212

Shelley’s hero Verney compares Martha’s success to the failures of guidance from landowners motivated by “benevolence”: “The poor perceived that the rich possessed other means of preservation than those which could be partaken of by themselves, seclusion, and, as far as circumstances permitted, freedom from care” (213). “Seclusion” and “freedom from care”—the ability to self-isolate without losing food and shelter—was key to effective quarantine then as now. Shared experiences, Shelley suggests, are important to trust and therefore to effective guidance. Verney, connected to government, talks to Martha and develops a “plan” that would expand her model and support it with training and standards: “I resolved therefore to go from village to village, seeking out the rustic archon of the place, and by systematizing their exertions, and enlightening their views, encrease both their power and their use among their fellow-cottagers” (213). But Shelley does not suggest the plan was implemented. In the next sentences, Verney turns to a despairing account of political turmoil and a population, weary of plague, that “endeavoured to exchange terror for heedlessness” (213) and so crowded into public places. Like Frankenstein’s mother, they are unwilling to wait until it is safe.

While Shelley imagined a community-centred approach to healthcare, her friend and fellow novelist Lady Morgan urged other reforms. In The O’Briens and the O’Flahertys (1827), a novel about colonial and political failures in Ireland, she wrote of Dublin:

In such thickly populated and ill ventilated “vicoli,” the plague was propagated. . . . The wisdom of our ancestors, who saw no inconvenience in what their fathers had borne, and admitted no remedy that came in the form of innovation, continued to reject, with equal tenacity, wide streets and inoculation: as equally subversive of social order, and opposed to God’s providence in the government of the world. (314)

In a footnote, Morgan uses even stronger language: “England, the most fanatical and bigotted country in Europe, has likewise opposed itself, with the greatest obstinacy, to the practice of vaccination. The native land of Jenner lies open . . . to the ridicule of Europe, for its imbecility respecting its ultra attachment to small-pox” (314n).

Before they could see viruses under a microscope, they knew that more could be done to reduce the spread of disease. Writers with political interests, such as Equiano, Shelley, and Morgan, recognized institutional and cultural barriers to effective public health.

About the Author

Julia M. Wright, FRSC, is George Munro Chair in Literature and Rhetoric at Dalhousie University. She is the author of four monographs and has edited or co-edited a further eleven volumes. Her research is primarily concerned with British and Irish literature around 1800.

1 Kevin Siena, Rotten Bodies: Class and Contagion in 18th Century Britain (Yale University Press, 2019), 98-99.


Equiano, Olaudah. The Interesting Narrative of the Life of Olaudah Equiano, or Gustavus Vassa, the African. The Classic Slave Narratives. Ed. Henry Louis Gates Jr. Penguin, 1987. 1-182.

Morgan, Sydney (Lady). The O’Briens and the O’Flahertys. 1827. Ed. Julia M. Wright. Broadview Press, 2014.

Shelley, Mary Wollstonecraft. Frankenstein. 1818. Ed. D. L. Macdonald and Kathleen Scherf. 3rd ed. Broadview Press, 2012.

—. The Last Man. 1826. Ed. Anne McWhir. Broadview Press, 1996.

Siena, Kevin. Rotten Bodies: Class and Contagion in 18th-Century Britain. Yale UP, 2019