by Stephen Wade
The version of Sarah Jacob’s eating disorder then, allies more with notions of family and social stereotyping and dominance than with body shape, slenderness and acceptability. In fact, all the evidence of her behaviour, sitting up in bed and reading aloud, writing poems and talking about her beliefs, suggests that she never gave a second thought to how she would look; clearly, as descriptions of her show and the autopsy confirms, she was happy with her layer of fat. But what the medical facts do show is that there was an illness deep down, any one of many we have looked at. Those ‘sunken eyes’ that Dr Lewis noted, tell a story of that more hidden Sarah.
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Anorexia, Sarah and Sir William Gull
Nothing to do but work,
Nothing to eat but food…
Benjamin King: The Pessimist
In the reply to a question in parliament about the costs of the prosecution of the Jacobs, Mr Stansfield, Secretary to the Treasury, gave this reply:
The larger and more liberal scale of costs allowed in the inquiry into the case of the Welsh Fasting Girl arose from the fact that the inquiry was conducted by the Treasury Solicitor, and the rule was that in inquiries of that kind… the scale of costs adopted was different to the scale adopted in the case of ordinary prosecutions. In these cases, it was within the discretion of the Treasury whether to employ counsel in the preliminary investigation or not. Looking into the difficulty of the law involved in the case, to the peculiar nature of the case, to the great public interest excited in it, and the strong feeling which it aroused,… the Treasury Solicitor thought he was fully entitled to employ counsel.
If we bear this in mind when we reflect that Sir William Gull, physician to the Queen and influential figure at Guy’s Hospital, coined the term ‘anorexia nervosa’ in a lecture of 1873, then the absence of reference to Sarah Jacob in his work is remarkable. Gull had given a talk to the British Medical Association in 1868 at Oxford on ‘a peculiar form of disease occurring mostly in young women and characterised by extreme emaciation’ as Sarah lay in bed during the main phase of her fast. The fact is that he had become concerned with anorexia as we know it today. This very special trial of Evan and Hannah Jacob in Carmarthen may well have interested him, but Sarah’s case is not even a footnote in his research. In fact, William Gull was a physician at Guy’s between 1851 and 1866, so he had resigned just a year before the onset of Sarah’s illness.
The Jacob case had a great impact on the popular view of eating disorders, but stayed firmly located in mystery and spectacle, rather than being of much importance medically. So if we ask the question, did her story have an impact on research into and knowledge of anorexia, the answer is yes, but not until after a long interim period in which there was a massive difference between the medical work done by Gull and others on the one hand, and by the more ‘show biz’ aspect which persisted under the ‘fasting’ spectacle.
William Gull’s work on anorexia has been rather overshadowed by his connection to two major subjects in crime history: Jack the Ripper and a would-be assassin of Queen Victoria. The Ripper link is ridiculous but has prompted a few books and films, stemming from the supposed Ripper suspect in the royal family, where Gull has been alleged to be the doctor working with the man of royal blood who ventured into Whitechapel to do his despicable deeds of slaughter. One of Gull’s patients also suggested as the Ripper. Gull took an interest in the forensic side of his profession, including having an appointment as superintendent of Broadmoor (for which H.A. Bruce was responsible).
Gull’s case studies of Miss A, Miss B and Miss K did a great deal to publicise knowledge of anorexia. Photographs of his patients were published in papers he produced for his peers, and one in particular, Miss D, shows the kind of emaciation we now associate with the condition. A French doctor called Lasegue was working on the same lines independently, and together, their work provides a clear example of eating disorders in complete contrast to Sarah’s case.
Gull first saw and recognised the kind of behaviour that was happening around Sarah, which was, because of Mr Daniel’s humane attempt to feed her, one of the central preoccupations at the trial. Gull wrote: ‘The family has but two methods at its service which it always exhausts – entreaties and menaces – and which both serve as a touchstone. The delicacies of the table are multiplied in the hope of stimulating the appetite; but the more the solicitude increases, the more the appetite diminishes.’ Generally, the place of fasting girls within this clinical description began to be denigrated and criticised. Their behaviour was beyond any kind of ‘common sense’. H. Gethin Morgan has pointed out that in the early twentieth century, there was hostility towards fasting girls. He quotes Samuel Gee: ‘a young maiden with small experience of the world expects more from life than life can give: the sympathy desired is not forthcoming, hence dissatisfaction and discontent.’
We can conclude then, that Gull’s amazingly advanced work fell on deaf ears with regard to general opinion. He recognised the source as a morbid mental state, something outside the conventional hysteria though: ‘The state of quietude – I might almost say a condition of contentment truly pathological. Not only does she sigh for recovery, but she is not ill pleased with her condition, notwithstanding all the unpleasantries it is attended with. In comparing this satisfied assurance to the obstinacy of the insane, I do not think I am going too far.’ In other words, concurrently with Sarah’s case, Gull had perceived that this was essentially a mental illness, not a state of mind which was somehow stubborn, contrary and integrally a part of his young females were socially ‘constructed’ by the Victorian ideology.
Gull’s work was before its time. He had perceived the real inner complexity of the condition, and that knowledge would have perhaps overridden the process of law a few decades later. Gull was, in the first phase of his studious life, self-taught in some respects, then learned in an ad hoc manner from different clergymen as he acquired a classical foundation to his intellect. Then he began at Guy’s and served an apprenticeship, gaining the medical qualifications at the time when the new standards of the profession were being defined and controlled. But he had known much more than an Oxford college and the medical school: he was born the son of an Essex wharfman, and had progressed, as the historian of Guy’s put it, ‘by sheer intellectual power and force of personality’.
It needed, perhaps, that kind of autodidact, a lone scholar with a wide span of interests, to advance the knowledge of such an illness – something entirely organic to the Victorian mindset, but not at all understood. The Jacob case had highlighted the sheer depths of ignorance in that respect.
Gull’s insight that the condition related to ‘the obstinacy of the insane’ was a considerable advance, but the authors of medical reference works for decades afterwards had not absorbed and inwardly digested that fact. After all, this was an age when another illness, epilepsy, was so little understood that it led to inhuman and horrendous decisions in the courts. In 1876, when William Drant killed the parish constable at Horncastle in Lincolnshire, it took a doctor, who initially wrote to The Times, to explain that the accused clearly had epilepsy and should not hang, to save his life. Henry Maudsley had luckily read an account of the killing and saw a pattern of behaviour he knew from his work with his patients. He wrote that this was a case of ‘epileptic mania… well know to have most furious and dangerous consequences’.
Epilepsy, like anorexia and other conditions with an essentially mental malaise at the heart of the anguish, was still beyond the range of the knowledge of most medical men at this time. Gull, like Maudsley, learned from the study of patients and from close observation and reporting.
Considering these comparisons, the conclusion of Richard Ireland, on the legal aspects of the Jacob case, becomes even more significant. He wrote that by all known criteria, the trial at Carmarthen should have become a leading case, instead it was destined to be marginalised. That simple fact tells us all we need to know about why various kinds of eating disorders did not become
a centre of medical study until a very long time after 1869.
With this in mind, the impact of Sarah’s case, in the years up to the end of the century, was somewhat limited, stuck in a limbo where intellectual discussion never really moved on. We may see this in William Hammond’s book in 1876, Spiritualism and Allied Causes and Conditions of Nervous Derangement, in which he concluded: ‘Thus ended one of the most remarkable and interesting histories of human folly, credulity and criminality which the present day has produced. Comment upon its teaching is scarcely necessary, but the thoughtful reader will not fail to perceive how important a bearing it has upon the whole subject of belief without full and free inquiry, and how all the facts which science has gathered during ages of painful labour, go for nought…’.
The term ‘fasting girl’ became a glib and reductive way to label anything from a circus performer to a freak show. Even Louise Lateau, a famous Catholic mystic with alleged stigmata, was referred to as a ‘fasting girl’ when she died in 1883, though her fast began at the beginning of 1871 and she caught public attention when she ostensibly lived by only eating the bread of the eucharist.
The massive and widespread coverage of Sarah’s story during the fast (and those of other young women) planted a set of images which remained in the popular imagination, and were too powerful to be counteracted by serious medical research.
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Her Life After Death: Fasting Girls and Hunger Artists
No-one could possibly watch the fasting showman
Continuously, day and night, and so no-one could produce
First hand evidence…
Franz Kafka: The Hunger Artist
The story of Sarah Jacob, her short life and sensational death, has had a remarkably powerful afterlife. The opposition between science and superstition, nature and supernature was enduring, and in some contexts, has remained. Something in us wants to accept that there could be such a thing as anorexia mirabilis in modern times, and that little girls can live without food for years. Something in us does not like facts that tend to crush wonder and astonishment.
In some ways, the story of Sarah Jacob set a template for stories of popular fascination and not much more. Louise Lateau was such an example. The papers reported on this miraculous phenomenon from the same perspective as they had taken vis a vis Sarah. In Germany, a publication called Louise Lateau, die Stigmatisirte von Bois d’Haine (The Stigmata of the Bois d’Haine) reached nine editions, and 50,000 copies had been sold. Part of the interest in the book was that it was written by a Professor Rohling of the Academy in Munster. Here again is something allegedly miraculous, ratified by a learned professional who commanded respect.
Every possible miraculous feature of sainthood was ascribed to Lateau, but it was her fast that was stressed, and a report in The Times was headed ‘A Fasting Girl’. The key wording, with Sarah in mind, is: ‘More recently she has found sleep and food unnecessary to existence, and we are informed that for the last three years she has only eaten a wafer daily and drunk two spoonfuls of water weekly. During all this time she has never slept’. That language is not unlike the statements placed on billboards outside travelling raree shows and feasts; it is almost the same expression as a Barnum announcement before a parade of his wonders and prodigies.
Far more interesting and important for the Jacob story, is how we are to understand it with regard to spirituality and Christian belief. I have deliberately left this in the background until now, because when we consider how Sarah’s life and death provided that template for future ‘miraculous’ tales, we need to look at Wales in particular and at evangelical Christianity at the time. With that Welsh context in mind it is instructive to look at Judah, a play by Henry Arthur Jones, performed at the Shaftesbury Theatre in London in May 1890. The production merited a long and reflective review in The Times in which the writer defined it as being somewhere between a play and a philosophical thesis. The story centres on a Welsh Presbyterian preacher, Judah Llewelyn, and the arrival of a ‘miracle worker’ called Vashti Dethic. The reviewer summarises the central opposition of the play: ‘Lord Asgarby is a man of culture, one of his intimate friends being Professor Jopp … who happens to be at Asgarby Hall on a visit, (he) openly ridicules Miss Dethic’s pretensions, and even the mayor admits that while miracles are right enough when assigned to some remote period of antiquity, it is rather indecorous, not to say absurd, to have them brought to one’s door.’
The play’s other dramatic strand contains a local fasting girl, for whom Lord Asgarby had done all he can, but now a miracle is required to save her. The girl wants to be the subject of an attempt at something miraculous, and her father, as the reviewer puts it, ‘yields to her caprice’. Judah Llewelyn, the preacher, becomes a disciple of Dethic. His ministry has been, in the words of The Times, ‘of an “awakening” character and a confession of his profound faith… brings us at once to the kernel of the play – the contrast between certain forms of religious belief and science.’
The source of Judah’s message is in a new religion and a confrontation between Jopp and Judah follows. The reviewer is aware that the shadow over the play is the Jacob case, noting that the Welsh Fasting Girl was simply a case of ‘fanaticism or hysteria’. Jones includes a love relationship between the fasting girl and Judah, which is his downfall, as he begins to lie, and is challenged by Jopp to confess that he has created an imposture in the fasting girl.
The significance here is that for the character of Judah, the age of miracles has not ended. Although, as he watches the girl (through the eyes of love) he sees the fraud being enacted between the girl and her father, Judah still wants to believe in miracles. Underpinning this desire is the undeniable fact that from the pulpit and in tracts, week after week, Christians had been told of miracles, and that this had been happening as long as there had been versions of the Bible in English and in Welsh.
Darwin, of course, challenged the Bible as literal truth, and Sarah’s growing up occurred in the aftermath of the publication of On the Origin of Species in 1859. But the metaphorical truth of miracles remained, persisting in the always increasing literature of Christ and redemption. Still, the truth is that underlying churchgoing and the boom in religious publications, was a deep unrest and uncertainty in religious matters. The poetry of the mid-century, post-Darwin, is riddled with doubt and questioning. Doubters have always asked for miracles, as mere preaching and sermonising does not convince doubters into suddenly relocating their faith.
The century as a whole suffered one religious controversy after another, and the 1860s started with one of the most powerful and divisive of them all. The publication of a book called Essays and Reviews brought out, amongst other things, the rift between intellectual Christians and those who followed biblical teachings without question, living Christian lives modelled on Jesus and his teachings. The book was conceived by H.B. Wilson and Benjamin Jowett, the future Master of Balliol College, Oxford. The contributors refused to submit to ‘this abominable system of terrorism which prevents the statement of the plainest facts and makes theological education impossible.’ Naturally they upset all kinds of bible adherents, and one of their key arguments has been summarised by Alec Vidler as: ‘Christianity no longer depends for its verification on external evidences, especially miracles, but on the appeal to moral and spiritual experience.’ This strongly criticises at the limits of having Christian belief and life values created by strict biblical teaching, in which there is no debate and questioning, so that miraculous subjects are accepted unthinkingly. Another essay in Essays and Reviews insisted that the story of creation ought to be taken as just a Hebrew myth.
The impetus of the book was to encourage more profound knowledge of Christian literature by studying books with a knowledge of their context and historical period. One of the central ideas in the debate around the book was that miracles performed by Christ were not to be taken as proof of his powers, but as something that would happen anyway, given his nature and identity.
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The response was a heated debate. The authors of Essays and Reviews were all Church of England churchmen and academics. Their book sold 22,000 copies between 1860 and 1862. Then the authors were threatened with a prosecution in the church courts, after the Archbishop of Canterbury and other church dignitaries expressed their disapproval. The new spirit of rational and scholarly enquiry was being applied to that numinous element in life which was nurtured by literal truths in miraculous Christian narratives.
So miracles and other challenging notions from the Bible took centre stage as the teaching and learning of Christianity was open for revisionary thought. The 1860s raged with that debate. Robert Baden-Powell made a key contribution to it with his essay ‘On the Study of the Evidences of Christianity’. In one of the plainest statements he made, which sets him beside the new medical minds who examined Sarah, he states:
If at the present day any very extraordinary and unaccountable fact were established before an unbiased, educated, well-defined individual, and supposing all suspicious of imposture out of the question, his only conclusion would be that it was something he at present was unable to explain; and if at all versed in physical studies, he would not for an instant doubt either that it was really due to some natural cause, and that if properly recorded and examined, it would at some future time receive its explanation by the chance of discovery.
In fact, the paragraph above, when applied to the Rev. Jones, who wrote to The Welshman saying of Sarah’s case that ‘Medical men persist in saying that the thing is quite impossible, but all the nearest neighbours, who are thoroughly acquainted with the circumstances, entertain no doubt whatever on the subject, and I am myself of the same opinion’ makes him clearly the kind of Christian who was the opposite of Baden-Powell’s ideal student of the ‘extraordinary and unaccountable’.