Summary:

This history of western medicine focuses on British life in the eighteenth century. Williams begins his treatise by wondering if "we realize sufficiently what we have escaped by being alive in the twentieth, not the eighteenth, century." He then catalogues in the subsequent 12 chapters the agonies not only of illness but also of medical treatment in the 1700’s.

Topics are wide-ranging and include blood-letting, parturition, infant malnutrition, rampant infectious diseases, maltreatment of the insane, surgery prior to anesthesia, water therapy, and military medicine. Primary source quotations interspersed in the narrative add to the drama. For example, the deposition of a widower (his wife died while pregnant) is quoted: " . . . Being taken ill of a paine in her right side under her short ribb together with a great difficulty of breathing having but 14 weeks to go with Child Mr Hugh Chamberlen Senr was sent for to take care of her, who thereupon gave her in the space of nine days four vomitts, four purges, and caused her to be bled three times to the quantity of eight ounces each time: Then gave her something to raise a spitting after which swellings and Ulcers in her mouth followed . . . . " (p. 31)

A few medical advances at the close of the century are also described, notably the smallpox vaccine developed by Jenner and the administration of First Aid to wounded soldiers at the frontlines (developed by Larrey). The text is accompanied by black and white illustrations, such as an inside view of Bedlam (Bethlehem Hospital) by William Hogarth (A Rake’s Progress, plate VIII).

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This thoroughly researched book helps us understand John Keats's life and work in terms of his medical training. Goellnicht argues that, contrary to some critics' view that Keats was "anti-scientific" or "anti-intellectual," Keats incorporated much of the knowledge gained from his six years of medical training into his poetry.

The book begins with a chapter of biographical information about Keats, emphasizing the nature of medical training in the early nineteenth century, but includes Keats's self-diagnosis of tuberculosis. The heart of the book consists of four chapters, organized by scientific topic, which relate the specifics of Keats' s medical training to his writing: Chemistry, Botany, Anatomy and Physiology, and Pathology and Medicine.

Excerpts of Keats' poetic and epistolary writing are examined in each of these chapters in light of Keats' scientific and medical knowledge. For instance, in the chapter on Botany, the uses of specific botanical species in his writing are examined in terms of what was known of materia medica (see annotation for Ode on Melancholy. Furthermore, the author explores Keats's interest in plants and trees as metaphors for life, such as his interest in "the flower as a vital, but passive, being that exists in a state akin to negative capability."

The author concludes the book with a summary statement about each of the chapters (e.g., " . . . from pathology he adopted the approach of viewing aspects of life, in particular love and poetic creativity, in terms of morbid and healthy states . . . ") and also the caveat that the book is not meant to in any way diminish other profound influences on Keats, such as his interactions with other Romantic poets. Goellnicht notes, however, that Keats himself united the worlds of medicine and poetry in his poem, "The Fall of Hyperion," in which he describes the poet as a physician.

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Showalter identifies clusters of syndromes, or mini-epidemics, which she suggests represent late-twentieth century manifestations of the entity which was called hysteria in nineteenth century western culture. Opening with the history of psychiatry's involvement in hysteria in the time of Charcot and Freud, she traces the replacement of hysteria or conversion reaction by modern hysterical analogues such as: chronic fatigue syndrome, recovered memory, Gulf War syndrome, multiple personality syndrome, satanic ritual abuse, and alien abduction.

In separate chapters she examines each of these entities--how it presents, how it fits into her theory of mass hysteria as a cultural response to the millennium, and how it is being handled by health care professionals. Showalter contends that "Redefining hysteria as a universal human response to emotional conflict is a better course than evading, denying, or projecting its realities." (p. 17)

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This is a fascinating book on the relationship of science, medicine, and medical education to the rise of modernism in literature. Crawford uses Williams' work to connect the worlds of literature and medicine. He discovers in Williams' early poems and stories the dominant themes of clarity, cleanliness, objectivity, and authority; these themes also characterize early 20th century science. In Williams' later work, Crawford shows how the poet moved toward a more subjective and relativistic aesthetic, a change that reflects subsequent developments in science, especially physics, and signifies the emergence of "post-modernism" in literature.

Williams' first principle was clarity. As a physician, it was important that he observe human reality with a clear eye so that he could intervene to transform it. Direct apprehension of reality was also for him the source of poetry. He found beauty in the concrete experience of everyday life, but was skeptical of theories and abstractions. Along with clarity, cleanliness and objectivity also characterize Williams' worlds.

But clarity is not, in reality, so clear. To see clearly in a medical way, the physician must first learn to observe the world in a specialized manner in the "theater of proof," a metaphorical extension of the stage on which professors demonstrate anatomical structures or surgeons demonstrate operations. Like medical educators, the poet also creates a theater of proof. While the reader may experience clarity and simplicity in the poem, these effects are actually staged by the poet, who chooses "clean" words and manipulates reality to achieve the desired simplicity. In both medicine and poetry, the practitioner unveils the truth by using manipulative and authoritarian techniques.

In the last chapter, Crawford shows that Williams' later work presages a post-modern, relativistic world. While the earlier Williams speaks of clarity, simplicity, science, and authority, Patterson and the post-World War II poems reveal complexity, fragmentation, and subversion.

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Dr. Papper, a revered figure in the field of anesthesiology, questioned why it took so long for anesthesia to be "discovered": after all, pain and suffering existed long before the mid-nineteenth century. This book is a result of Papper’s graduate studies in literature and history and explains his thesis that "societal concern with pain and suffering, and the subsequent development of surgical anesthesia in the Romantic era . . . are outgrowths of Romantic subjectivity."

The book provides biographies of scientists, physicians and poets, such as Humphry Davy, Thomas Beddoes, Sr., Samuel Taylor Coleridge and Percy Bysshe Shelley, along with analyses of Romantic poetry as related to pain and suffering. Papper theorizes that the exchange of ideas amongst these intellectuals and the political upheavals of the time paved the way for society to recognize that the pursuit of happiness could include the relief of pain.

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William Osler served as one of Walt Whitman’s physicians from 1884, when he moved to Philadelphia to become Professor of Medicine at the University of Pennsylvania, until 1889, when he left Philadelphia for Baltimore. Osler was introduced to Whitman by a mutual friend, Dr. Richard Maurice Bucke, Whitman’s avid disciple and biographer. After his stroke of 1873, Whitman suffered from recurrent episodes of illness (perhaps small strokes?). Osler first paid a call to Whitman’s home in Camden at Bucke’s request and subsequently visited him on numerous occasions.

Published in this book for the first time is Osler’s unfinished 1919 manuscript for a lecture recounting his relationship with Whitman. Much of the book is a gloss on this short manuscript. The book actually deals as much (or more) with the remarkable figure of Richard Maurice Bucke, Whitman’s spokesman and the developer of a theory of "cosmic consciousness," as it does with the two title characters. In sum, Whitman respected Osler, but did not particularly like his sunny, optimistic bedside manner. Osler respected Whitman, but for the most part did not like his poetry. (Leon, however, discovered some handwritten notes on Osler’s copy of Leaves of Grass that suggest Osler grew in his later years to appreciate Whitman’s poetry.)

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On the first page, Morris summarizes his project in this book: to "describe how the experience of pain is decisively shaped or modified by individual human minds and by specific human cultures. It explores what we might call the historical, cultural, and psychosocial construction of pain." Contemporary Western culture tries to convince us that pain is nothing but an aspect of disease and, therefore, a medical problem. But pain only exists in human experience; nerve impulses are not pain.

In calling our attention to the social and cultural meanings of pain, Morris begins with Tolstoy's short novel, The Death of Ivan Ilyich (see this database). He then presents various images of human suffering: gender-based pain, as in Charlotte Perkins Gilman's, The Yellow Wallpaper (see this database: annotated by Felice Aull, also annotated by Jack Coulehan); religious views, as in the stories of Job and the Christian martyrs; the aesthetic ideal, as manifested in the romantic idea of the sublime as painful; social uses, as in satire and torture (see Kafka's In the Penal Colony, annotated in this database); the relationship between pain and sex, as in the work of Marquis de Sade; and tragic pain, as evidenced in Sophocles' Philoctetes.

Throughout the book, Morris refers to the "invisible epidemic" of chronic pain that exists in the United States today. This epidemic of chronic pain can be adequately understood and treated only by approaching it with a cultural model, rather than a disease model.

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Dr. Cassell examines the social and cultural forces that encourage the practice and teaching of a medicine that is governed by the disease theory. This theory discounts the impact of illness on the patient and ignores the suffering that the patient is experiencing. Cassell does not debunk science and technology, rather he encompasses them within the moral enterprise of medicine as tools for helping patients.

The ability to provide compassionate attention to the patient as individual (i.e., with unique values, life experiences, family interactions, etc.), trustworthiness and self-discipline are required characteristics of a "good physician." Cassell illustrates and personalizes the philosophical shift towards focusing on the sick person with stories and anecdotes.

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Jordanova posits that medicine and science "contain implications about matters beyond their explicit content." Namely, they have historically made assumptions about women and their relation to science/medicine. Jordanova explores this relation through seven chapters.

Particularly interesting is Chapter Three, "Body Image and Sex Roles." Here Jordanova discusses the wax models used by medical students in the nineteenth century to learn about anatomy. These models were almost always female and sometimes even had flowing hair, pearl necklaces, and other realistic details. Jordanova argues that this gendering was no accident. The route to knowledge is historically associated with looking deep into the bodies of women.

Chapter Five pursues this theme, commenting on how nature is often configured as a female whose secrets will be revealed by masculine science. The final two chapters address twentieth century representations, including the gendered nature of drug advertisements in in-house medical magazines.

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This book offers an insightful, well-reasoned interpretation of the nature of medicine. Hunter, an English professor who teaches and coordinates humanities programs at a medical school, observed first-hand how an academic medical center functions--she joined various teams during their multiple rounds and conferences for two years. In sum, she "behaved rather like an ethnographer among a white-coated tribe." The resultant book details the profound importance of narrative in medicine.

Narrative is integral to the medical encounter, to communications by and about the patient, and to the structure and transmission of medical knowledge. For example, the patient's story is told to and interpreted by the physician, who then tells another story of the patient, in case format to other physicians, and records that story in a formulaic chart entry. Hunter observes that most of the rituals and traditions of medicine and medical training are narrative in structure, and explains why narratives such as cautionary tales, anecdotes, case reports and clinical-pathological conferences are central, not peripheral, to medicine. The thesis is further developed to maintain that, if the narrative structure of medicine is fully recognized by physicians, they will attend to their patients better and acknowledge the details and importance of their patients' individual life stories.

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