Hektoen International

A Journal of Medical Humanities

A “most perfect interchange”

Satyabha Tripathi
Lucknow, Uttar Pradesh, India

The Doctor. Luke Fildes. 1891. Tate Gallery, London. Via Wikimedia.

“[Lydgate held] the conviction that the medical profession as it might be was the finest in the world; presenting the most perfect interchange between science and art; offering the most direct alliance between intellectual conquest and the social good […] he was an emotional creature, with a flesh-and-blood sense of fellowship which withstood all the abstractions of special study. He cared not only for ‘cases,’ but for John and Elizabeth.”1

George Eliot’s description of the young Dr. Tertius Lydgate in Middlemarch not only gives us one of the most interesting, fleshed-out medical characters in Victorian literature, but also serves as a representation of the way common perception of physicians changed over the eighteenth and nineteenth centuries.

Fresh from his training in London, Edinburgh, and Paris—the capitals of scientific thought in that era—Lydgate is a physician-scientist whose goal is to study the “primitive tissue”; in essence, to develop and elucidate the nascent cell theory. He settles in the town of Middlemarch with the conscious aim to not “have his vanities provoked by contact with the showy worldly successes of the capital,”2 so that he can devote his leisure time to the scientific study of tissues.

At the same time, he takes his duties as physician seriously. He comes to his profession both as a compassionate and serious-minded doctor, and as a reformer of the establishment: he decides, at the outset of his career, to “simply prescribe, without dispensing drugs or taking percentage from druggists,”3 thus averting the temptation of making a profit from overprescribing drugs as was common at the time. He is also an ardent supporter of the local hospital and resents the interference of parochial interests that disturbs its functioning.

His conception of his vocation is one of combining day-to-day practice with histological research, and to do good by both means: “Such was Lydgate’s plan of his future: to do good small work for Middlemarch, and great work for the world.”4

Lydgate as a person is not without significant flaws, but as a character he is illustrative of a new view of the scientist as someone who, while often working in isolation on abstruse topics inaccessible to most, still cares for the people, in both the general and individual sense of the word. We see other examples of this humanized and caring view of the profession in contemporaneous literature of the mid- to late-Victorian era.

One such instance is the protagonist of Anthony Trollope’s Dr. Thorne. Dr. Thorne is, for all his innate pride of family, intrinsically empathetic to and supportive of those in either physical or emotional pain. Gaskell’s Wives and Daughters also presents the duty of a doctor through the character of Mr. Gibson, as one involving not only scholarship but also empathy. The same novel also gives us some views of science as a mode of attaining social éclat through the reputation and cachet it gains Roger Hamley; but while his scientific pursuits are shown to add value to his character, his main virtue as a person is a broadminded kindness.

Eliot began writing Middlemarch in the mid-Victorian era but set her work in the late 1820s, a period at the cusp of brilliant strides in the biological and medical sciences. The hitherto accepted medical paradigms were being challenged and transformed—moving away from the miasmas to germ theory, preformationism to epigenesis, spontaneous generation to cell theory, vitalism to reductionism. These developments, even with their limitations and drawbacks, proved to be essential steps in bringing students of medicine to stand on equal scientific ground with their chemical and physical brethren. This process of structurization was reflected on the sociological scale in the increased formalization and regulation of the medical profession (starting with the Apothecaries Act of 1815) and in the rise of hospitals as hubs of medical knowledge rather than simply charities.

It is suggestive of the power of medicine to link the abstract with the concrete that the humanization of science and scientists occurred most vividly at the turning of point of medicine as a science.

Physics was the first field of study to benefit deeply from scientific thought. Astronomy and celestial physics were transformed, through the work of (among many others) Copernicus, Bailly, and Newton, into a discipline illustrative of the application of the principles of the Scientific Revolution and the Age of Enlightenment, with their emphasis on empiricism and the sovereignty of reason.

“A new view of nature emerged, replacing the Greek view that had dominated science for almost 2,000 years. Science became an autonomous discipline, distinct from both philosophy and technology, and came to be regarded as having utilitarian goals.”5

This was followed, in the late 1700s to early 1800s, by discoveries in the properties of elements, gas laws, and atomic theory through the work of Gough, Dalton, and Davy. But even as great strides were being made in chemistry, medicine remained a black box of sorts, committed to the untested and unsystematic humoral theory, with physicians and apothecaries creating and prescribing medications with remarkably little scientific support.

At this time, science was still seen as remote and impenetrable. The counter-movements of the Age of Reflection and Romanticism reflect how scientific progress was perceived as being at best divorced from, and at worst in opposition to, the social good. This led ultimately to the emergence of a Romantic movement within science itself, rejecting a purely mechanistic view of nature. It was within this context of anti-reductionism that the term “biology” was created by Lamarck, who believed that “the phenomena of living nature cannot be understood in the light of the laws of physics but require an ad hoc explanation,”6 an idea more familiar to us now as emergence.

This course correction in the philosophy of science, was perhaps equally as important as reductionism to our present knowledge of biology—for viewing biology as a discipline to be pursued in itself, and not as something that can be explained satisfactorily using only physics or chemistry.

This paralleled the change in the way people perceived scientific pursuit. The era of the brilliant but unapproachable scientist gave way to the era of celebrity scientists who, while still working on rarefied questions, did intermingle with their fellow man and condescended to share their knowledge with the layperson. In this period (from the late 1790s to mid-1800s) we see the rise of public lectures in science, such as those by Sir Humphry Davy and Michael Faraday, which were not only educational seminars, but sought-after social events for the aristocracy. The publication of scientific textbooks geared towards the general public also increased, with writers such as Margaret Bryan, James Ferguson, Jane Marcet, and Mary Somerville composing books that made science accessible to newcomers and became established texts for decades.

This more human and democratic element of scientific pursuit is reflected in the literature of the time. Maria Edgeworth’s works provide an intriguing example of not only the flux the reputation of the medical profession was undergoing, but also its evolution as a scientific field with systematic and technical underpinnings—a formalized theory of pathology and medicine, rather than solely the empiric therapy of previous eras. In earlier works such as Belinda and Letters, science (and scientific education) is offered as an antidote not only to ignorance and quackery, but also to over-emotionalism and a lack of direction—as a method of creating a logical habit of mind.

In the later novel Patronage, Edgeworth presents Dr. Erasmus Percy as an embodiment of the ideal of a modern man of science, who comes into conflict with the established norms of his profession. In one instance, his refusal to submit blindly to the “fashionable” hypotheses that two competing physicians espouse, and his insistence on making his own examination of the patient, lead him to success and fame. In another case, his compassion for an injured laborer loses him the favor of a would-be mentor. Percy resembles other contemporary literary and real scientific figures in later attaining celebrity (as a proxy of his success and a validation of his abilities), but this celebrity is not distanced from the general mass of humanity.

In Percy, as in Eliot’s Lydgate, we see the evolution of the common perception of physicians and scientists as more than starkly logical; the development of the well-rounded and benevolent medical man, admirable not only for his scientific commitment but also for his humanity, who can truly embody that “most perfect interchange” between science as intellectual pursuit and science as service to humanity.


  1. George Eliot, Middlemarch (New York: W.W. Norton and Company, Inc., 2000), p.93.
  2. Ibid, p. 94.
  3. Ibid, p. 94.
  4. Ibid, p. 95-96.
  5. Encyclopaedia Britannica, 15th ed., s.v. “Physical Sciences.” Chicago: Encyclopaedia Britannica, 2009.
  6. Bossi, Maurizio and Poggi, Stefano (eds.) Romanticism in Science: Science in Europe, 1790–1840. (Boston: Kluwer Academic, 1994), p.54.

SATYABHA TRIPATHI, PhD, obtained her Bachelor of Science in Biology from the University of Houston and her Ph.D. in Molecular and Cellular Biology from Tulane University. She is interested in vascular and lymphatic biology and an ardent reader of world literature.

Highlighted in Frontispiece Volume 14, Issue 2 – Spring 2022

Fall 2021




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