In the closing decades of the nineteenth century, both medical and literary writers sought to come to terms with the perceived problems of modernity, exploring the consequences for both body and mind of the emerging forms of a pressured, deracinated society. With her ‘fits of nervous dread’ and descent into mental turmoil, George Eliot’s heroine Gwendolen Harleth, from Daniel Deronda (1876), becomes a key figure in late-Victorian representations of the over-stimulated, nervous, and rootless creature of the age. George Gissing, in The Whirlpool (1896), similarly explores the life of a nervous young woman, Alma Fotheringham, caught up in the trammels of late-century city life. This essay focuses on Eliot’s and Gissing’s engagement with medical discourses of the era in their pessimistic case studies of the ways in which pathological forms of economic and social life are imprinted on the mind and body, from the gambling salon and debased culture of the health spa in Eliot’s novel to Gissing’s explicit deployment of fin-de-siècle discourses of degeneration. It also overturns commonly held assumptions that we need to wait until Modernism for a thorough diagnosis of the diseases of modernity.