Well, this one didn't work for me. It wasn't horrible writing, and I didn't get turned off because it made me squeamish. It just tried too hard. 
 Firstly, there are way too many descriptions of things being gross for the sake of grossing out the reader. The mutton is rotten, the pears are sickly, the bad tooth is casually pulled out, there's a horrid stench in the room, the slop pail has different types of bodily fluids... It all just becomes overkill. (Pun wasn't intended, but I'll allow it!) 
 Secondly, the book drags on too long. Witnessing scenes from different perspectives is at times clever, but mostly unnecessary and drawn-out. What if this was instead a novella? I think I'd be much more captivated. 
 Worst of all, really? I didn't enjoy reading this book. I was ready to be finished before I even hit the halfway point, and considered DNF'ing it. But then I'd find moments of interesting passages and I'd soldier on. 
 I have to say, while reading I mainly had one recurring thought: is this book necessary? Which is never really a good sign.