Sarah Jacob the 19th Century Welsh Fasting Girl

Anorexia Nervosa and Victorian Medical and Public Opinion

Jun 22, 2009

In 1869 a young Welsh girl fasted to death. It was claimed that for more than 2 years, she had lived without food. Her case divided public and medical opinion.

Sarah Jacob was born on 17th June 1857. She died in 1869, aged 12, her fame having spread throughout Britain and abroad. Many hundreds of people had travelled to her isolated home to see the “Welsh fasting girl”.

The Origin of Sarah Jacob's Illness

Sarah’s illness started more than 2 years before her untimely death when she woke with a pain in her stomach. The pain increased and she was put to bed where she was to remain until her death. During the 6 weeks a young physician attended her, she was unconscious, in a sort of fit and rigid on her left side.

Start of Sarah Jacob's Eating Disorder

On recovering consciousness, her parents tried to feed her. They found her unable to swallow, vomiting everything given her and having “fits”. By October her father thought she looked somewhat better despite not eating. Sarah’s parents decided to stop offering food; fearing doing so was making her symptoms worse. They noticed an immediate improvement; the hysterical outbursts, vomiting and severe fits stopped.

Eating Disorders and the 19th Century Press

Sarah might have remained a local curiosity were it not for her vicar. Initially sceptical, the Reverend Jones was soon persuaded that his parishioner really was surviving without food or water. He wrote to the papers stating that there could be “no doubt whatever” that Sarah was a true fasting girl: she had eaten nothing for 16 months. Sarah became an instant tourist attraction: thousands made the long journey to the small isolated farmstead in Lletherneuadd to see the girl who lived on air. The press, at home and abroad, followed her story avidly.

Medical journals attacked the credulity and superstition of those claiming to be witness to a miraculous ability to live without sustenance. The Reverend Jones came in for particular criticism. In an attempt to prove no deception was involved, Sarah’s father, the Reverend Jones and other respected men from the community, agreed a watch would be kept over Sarah. It was not a success. Sarah’s bed wasn’t checked for hidden food; her parents and sister were allowed to visit her whenever they chose. Strangely, given the child was said to have swallowed no liquid for a period of months, Sarah’s frequent bedwetting was not seen as suspicious. A second, more sophisticated watch was organised by Guy’s hospital in November 1869. Four nurses were sent to watch over Sarah day and night. By the fourth day of the watch, Sarah had weakened dramatically. Her pulse raced, her bed sheets were frequently soaked. By the 17th December, she was dead.

Autopsy, Inquest and Trial in the Sarah Jacob Case

Four days later, the autopsy found no disease or injury to cause death. Significantly, there was no sign of emaciation. The coroner recommended a verdict of manslaughter against the parents. The local physicians who had devised and supervised the final watch and Sarah’s parents were arraigned before magistrates. Only the parents were sent to trial. Found guilty of causing Sarah’s death, her father was sentenced to 1 year's hard labour, her mother pregnant with her 8th child, to 6 months.

Dr Fowler, Sarah Jacob and Anorexia Nervosa

The medical establishment placed the blame for Sarah’s death on the child herself. In 1871 Dr Robert Fowler made the link between fasting and neurotic behaviour. Fowler had observed Sarah in August 1869. He noted the rumblings from her digestive tract, her unconvincing fits, and the lack of any outward sign of emaciation. These symptoms together with her rapid eye movements and panicky voice were all indications of “simulative hysteria”. Fowler suggested a psychological basis to eating disorders. Two years later, Sir William Gull used the term “anorexia nervosa”.

Was Sarah Jacob the First Anorexic?

Fowler thought Sarah a “night-feeder”: the farm had a dairy attached. The autopsy had noted deep marks on the child’s toe and a hollow under one arm big enough to conceal a small bottle. The received wisdom over the years was that Sarah was a spoilt and hysterical child who came to love the attention first from her parents as they tried to persuade her to eat then from the numerous visitors. She always looked the picture of health. It was assumed she got up at night, possibly aided by one of her sisters, to eat in secret. Although the family made some financial gain (the visitors usually left gifts or money) argument raged as to whether they were complicit in the deception or duped by their daughter. Many commentators blamed the medical profession for organising the fateful watch. Trapped in her bed, observed closely night and day, Sarah Jacob was unable to get food or water in the way she had been doing for months. Until the end, not only did she refuse all offer of food, her father and the physician who first treated her persisted in the extraordinary belief that feeding her would kill her.

Sources:

The copyright of the article Sarah Jacob the 19th Century Welsh Fasting Girl in Georgian/Victorian Britain is owned by Paula Hellal. Permission to republish Sarah Jacob the 19th Century Welsh Fasting Girl in print or online must be granted by the author in writing.