Victorian class inequality

Victorian class inequality in Poor Things is a structure that reaches from the hospital ward into the home, the workplace, and intimate life. The novel presents poverty not simply as a lack of money but as exposure to preventable illness, restricted education, insecure family ties, and institutions whose care can reproduce the power imbalance they are meant to correct. Its arguments are voiced by characters with different positions and interests, but repeatedly converge on a central contradiction: the society that calls itself charitable permits avoidable suffering among the poor while reserving greater choice and protection for the wealthy.

Medical Care and the Class Order

Godwin Baxter describes public hospitals as institutions where doctors practise on poor patients while wealthy people arrange operations privately or at home. He contrasts this hierarchy with the private work of his father, Sir Colin Baxter, who operated in the family’s town house in winter and country house in summer. Sir Colin, he says, boiled his instruments and sterilized his theatre even when hospital boards dismissed aseptic medicine or treated it as fraudulent. Baxter’s criticism is therefore directed at both material inequality and professional authority: the poor bear the risks of medical practice, while powerful practitioners can deny the danger of their own methods.

Baxter’s ideal of medicine is prevention rather than the profitable treatment of illness. He argues that sunlight, cleanliness, exercise, fresh air, pure water, adequate food, and spacious housing would prevent much sickness, but that industrial production and the pursuit of markets block these improvements. His account connects working and living conditions to bodily health, then connects those conditions to political decisions. Medicine, in this analysis, puts a charitable appearance over an economic order that continues to expose poor people to disease. Baxter admits that his voluntary work in an east Glasgow clinic soothes his conscience, but that it cannot resolve the conflict: a complex transplant might require weeks of preparation and a thirty-three-hour operation, while poor patients could die or endure pain for want of ordinary surgery.

The novel also complicates Baxter’s condemnation of hospitals. He acknowledges that conditions have improved, but credits nurses as the practitioners most responsible for healing. His claim that most patients would recover if nursing continued even after doctors and surgeons vanished shifts attention from elite medical expertise to care work that is undervalued within the profession. The history of Ignaz Semmelweis, supplied in a note, sharpens the point: antiseptic practice reduced deaths in a Viennese maternity hospital, yet his superiors rejected his conclusions and forced him out. The cost of professional resistance fell on patients, while a poor doctor who tried to publicize the danger was marginalized.

Poverty, Industry, and the Body

Baxter extends the argument from hospitals to the conditions that create illness. He describes Glasgow as a city with exceptionally high infant mortality and argues that poverty can leave parents unable to afford a coffin, funeral, and grave for each child who dies. He also refers to babies born with severe malformations, some of whom cannot survive without assistance. In this account, the fate of infants is not separate from class: medical decisions take place within a society where families may lack the resources even to bury their dead, and where the profession’s response to suffering is shaped by social convention as well as clinical need.

His account of industrial Britain makes poverty a political outcome rather than an inexplicable misfortune. When the Napoleonic war ended, he says, unemployment and hunger prompted fears of revolution. Robert Owen proposed that businesses use profits above five per cent to improve workers’ food, housing, and schooling; Malthusian reasoning opposed better provision on the ground that the poor would have more children. Baxter argues that the actual response was not to remove deprivation but to contain its consequences through military barracks, police, jails, and deliberately grim poor-houses. Such institutions could separate children from parents and husbands from wives. His bitter conclusion is that hunger and disease weaken the population and make revolt less likely. The novel thereby links economic policy, coercive institutions, and the management of poor people’s bodies.

Class, Gender, and Social Reproduction

Duncan Wedderburn’s confession reveals how class hierarchy also governs sexual and domestic life. He says that working women were the only women with whom he felt at ease, while women of his own income group made him awkward and formal. At university, he discovered that two-thirds of the students shared this attraction, although many went on to marry women of their own class. Wedderburn presents his own relationships with working women as sincere, but says the social gulf prevented marriage. His account exposes the limits of personal affection within a society where class determines which unions are respectable and which remain hidden.

That gulf also shapes the lives of the children and mothers involved. Wedderburn says his few illegitimate children were not left uncared for: they entered the charitable institution of his friend Quarrier and were sent to Canada for domestic agricultural work on the expanding frontier of the British Empire. He insists that their mothers did not lose working days through their relationships with him, while admitting that irregular free time made him court several women at once. The episode is not presented as a simple escape from class prejudice. Charity provides an institutional destination for children whom their father does not raise, and imperial settlement turns their displacement into useful labour. His account places sexual freedom, wage work, childcare, and charitable intervention inside the same unequal system.

The novel sets this working-class experience against the constrained lives of wealthy women. Wedderburn describes them as ornaments and private pleasures of affluent men, with servants caring for their children after childbirth. Their relative comfort does not give them full control over motherhood or sexuality; they remain dependent on husbands and social expectations. Meanwhile, women who work in textile sheds endure years of exhausting labour. The contrast does not erase the difference between wealth and poverty. It shows that gendered subordination takes distinct forms across class lines, while the unequal distribution of domestic and reproductive labour helps sustain the whole order.

Education, Professional Authority, and Reform

The novel treats education as another means by which class power reproduces itself. In Wedderburn’s account, poor children learn to beg, lie, and steal because they need to survive, while prosperous parents teach moral prohibitions that their children’s schooling then complicates. Schools require pupils to disguise their thoughts and feelings while praising famous conquerors whose violence and seizure of property are celebrated. Baxter’s account of history similarly argues that accounts written by the beneficiaries of conquest can present the dispossessed as improved by their losses. Education does not merely impart knowledge in these passages; it teaches people how to interpret inequality, whose violence to admire, and whose deprivation to regard as deserved.

Bella Baxter’s medical training and later practice offer a practical challenge to the barriers around professional knowledge. Baxter explains that Britain has only four women doctors at the time, all educated at foreign universities, and proposes that Bella begin in charity nursing before assisting him and eventually attending medical college. Bella wants to care for little girls, mothers, and prostitutes, and to teach women effective contraception. Baxter and Archibald McCandless urge her to keep that intention private until she is able to practise, but concede that the timing of any public argument must ultimately be her choice. Her proposed work directs medical knowledge toward groups whose care is otherwise largely managed by people with different bodies and social positions.

Under the name Victoria, Bella later enrols at the Sophia Jex-Blake School of Medicine for Women in Edinburgh in 1886 and receives a medical degree from Glasgow University in 1890. In that year she opens the Godwin Baxter Natal Clinic near the Cowcaddens as a charitable foundation staffed by local women whom she trains. She deliberately sends capable employees onward once she has taught them what she can, encouraging them to help their neighbours or learn from another doctor. The clinic thus treats training not as a privilege to be hoarded but as knowledge to circulate. Her insistence that children should learn nursing and basic medicine also challenges the professional monopoly: ordinary people, she argues, should understand how to care for one another and recognize unhealthy housing and working conditions.

Work, Care, and the Limits of Reform

Victoria’s critique of horizontalism connects medical custom to social power. In her pamphlet Against Horizontalism, she argues that doctors may prefer patients to lie down because the posture makes the doctor feel stronger. She accepts that bed rest is necessary for some illnesses but maintains that childbirth is not a disease and can proceed more easily in a squatting posture. Her criticism extends beyond physical position: patients are also expected to trust medical authority without understanding their own bodies. Better health, in her view, requires both shared medical knowledge and the confidence to challenge harmful living and working conditions.

Her own working life makes the argument concrete. Between 1892 and 1898, Victoria bears three sons at two-year intervals, continuing clinical work until the last days of each pregnancy and returning soon afterward. She compares her circumstances with those of the poor women she treats, who cannot afford to stop working or remain in bed. Even her relative advantage rests on support from Archibald McCandless, whom she describes as a good wife to her. The phrase unsettles conventional divisions between male and female roles while underscoring that a woman’s ability to practise medicine depends partly on the care available to her at home.

Victoria’s later campaign also reveals the limits of charitable reform. Her public-health pamphlet attracts attacks from churches and newspapers; the Daily Express helps enlarge its circulation through a campaign to deprive her of the clinic. Some critics portray her proposals for school health education as revolutionary, while others object to her birth-control arguments. Victoria rejects commercial contraceptives as unhealthy and insists that sexual life should not be separated from everyday tenderness and care. Her ideas are controversial even among birth-control advocates, and publicity does not protect the institution she built. Across these episodes, the novel presents class inequality as durable precisely because it is embedded in work, education, professional jurisdiction, family arrangements, and public opinion. Reform can redistribute knowledge and care, but those who benefit from existing authority retain the power to obstruct it.