The ‘Welsh Fasting Girls’ and Anorexia Nervosa in the Victorian Medical Imagination

IntroductionOn December 17, 1869, twelve-year-old Sarah Jacob starved to death under medical supervision in her family home in the village of Llanfihangel-ar-Arth, Wales, in rural Carmarthenshire.By the time of her death, she supposedly had been fasting for over two years, and was suffering from a variety of physical symptoms, including partial paralysis on her left side, a series of "fits", and an inability to open her mouth.Ten years later and forty miles away, fourteen-year-old Ann Morgan died on November 9, 1879, in Borth, a seaside village in West Wales.In February 1878, Morgan allegedly had been fasting for over 100 days.Although she was discharged after undergoing treatment in the nearby Aberystwyth Infirmary, doctors speculated that she had been unable to recover fully from the physiological effects of the "fasting mania" and died from exhaustion ("Death of the Borth Fasting Girl" 2).During her fast, Morgan suffered from symptoms of hysteria, including an involuntary movement of her head when anyone was in the room with her ("The Borth Fasting Girl" 5).This article focuses on the public and medical reaction to two "fasting girls", Sarah Jacob and Ann Morgan, who died in Wales in the nineteenth century from complications related to food refusal.Using evidence from popular newspapers published in Britain from 1860-1890, along with articles from prominent medical journals including The Lancet, I discuss the differing attitudes toward Jacob and Morgan during their alleged fasts and shortly after their deaths.I shall situate the cases of the two Welsh Fasting Girls within their historical and medical contexts; provide an analysis of how the medical community characterized and proposed treating the girls' illnesses; and draw connections between the fasting girls and early cases of anorexia in the late nineteenth century.I argue that the fasting girl cases established a precedent for medically treating food refusal through force-feeding, leading to a clinical focus on the physical symptoms of a largely psychological illness.This body-over-mind approach to the treatment of eating disorders informed, and was informed by, a medical model that evaluated patients' recovery based on whether or not they gained weight and kept it on, emphasizing a focus on quantifiable outcomes in patient treatment that still remains influential today.Although the symptoms that Sarah Jacob and Ann Morgan exhibited were similar, the medical treatments in the two cases, occurring about a decade apart in similar rural settings, underscore an epistemological change that led to doctors treating fasting cases as medical crises rather than curiosities, public spectacles, or hoaxes.The Jacob case established that the human body could actually starve to death in a relatively short period of time.By the time Morgan had allegedly begun fasting, even short periods of food refusal had therefore become pathologized.The Jacob case is relatively well-known, but few records of Morgan's case exist outside of contemporary Welsh newspapers.Yet because the two "fasting girls" died in the same region of Britain only a decade apart, the differences in their medical treatment and the attention they received suggests how medical epistemology influenced public opinion.The effects of fastingeven alleged fastingthat were not considered dangerous at the time of Sarah Jacob's

Anorexia · Anorexia nervosa · Eating disorders · Psychiatry · Psychoanalysis · Welsh · Historical Studies on Reproduction, Gender, Health, and Societal Changes · History · Medicine · Psychology · Internal Medicine

• " Anorexia Nervosa."

  Open Access•W J Collins•The Lancet•1894

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