Show Less
Open access

What Literature Knows

Forays into Literary Knowledge Production


Edited By Antje Kley and Kai Merten

This volume sheds light on the nexus between knowledge and literature. Arranged historically, contributions address both popular and canonical English and US-American writing from the early modern period to the present. They focus on how historically specific texts engage with epistemological questions in relation to material and social forms as well as representation. The authors discuss literature as a culturally embedded form of knowledge production in its own right, which deploys narrative and poetic means of exploration to establish an independent and sometimes dissident archive. The worlds that imaginary texts project are shown to open up alternative perspectives to be reckoned with in the academic articulation and public discussion of issues in economics and the sciences, identity formation and wellbeing, legal rationale and political decision-making.

Show Summary Details
Open access

Negotiating Authority: Literary and Medical Configurations of Knowledge in 19th-Century America (Maria Kaspirek)

| 155 →

Maria Kaspirek

Negotiating Authority: Literary and Medical Configurations of Knowledge in 19th-Century America

Abstract: Presenting original evidence primarily from 19th-century medical journals, this essay reveals the hitherto neglected but substantial influence of literature on the consolidation of scientific knowledge on human nature. Against the background of a gradual institutionalization of medical science, the essay studies literary engagements with medico-scientific discourse, medical professionals’ reliance on literary observations in their diagnostics, the work of physician writers Oliver Wendell Holmes and Silas Weir Mitchell, and the medical case study as a literary genre. The essay also lays out how the medical profession began to pathologize writers and their work to consolidate its own discursive authority in the field. All examples called up here paint the relationship between medicine and literature as a mutually beneficial one; two fields that were engaged in the struggle for epistemological authority, vitalized by the public’s interest in health and human nature, sharing common subjects, negotiating a field of tension between democratization and professionalism, and united not only in a quest for knowledge but also for national identity and independence from European paragons. These observations also prove suggestive for the contemporary literature and science debates.

The relationship between literature and science has been the subject of an ongoing dispute for centuries (Arnold; Dewey; Snow), which has been given a new impetus through recent explorations by scholars such as Rita Felski, Marjorie Garber, and Ottmar Ette and Vera M. Kutzinski. While making strong claims about both the specificity and interdisciplinarity of literary frameworks for explaining human nature, these scholars decry the impression that, when it comes to conceptualizing the world and human’s place in it, literature has been relegated to the sidelines, and science has taken over. The following paper takes a step back to another so-called “age of science” – the 19th century (Knight), during which the alleged split between literature and science gained pace. By looking at antebellum medical discourse, I aim to draw attention to the particularly fertile exchange between literature and science at a time when the boundaries of those ← 155 | 156 → two fields intersected on various levels. The evidence presented in this paper, taken primarily from 19th-century medical journals, reveals the hitherto neglected but substantial influence of literature on the consolidation of scientific knowledge on human nature.

1 Medicine in Antebellum US America

The 19th century constitutes a time of profound change in US American society on all levels. Authority that formerly resided primarily within religious institutions shifted to other domains and was increasingly assumed by individuals operating under the designation of “scientist,” a term coined by William Whewell in 1834. Cultural and political discourse concentrated on the connection between morality and mental as well as physical health, and the welfare of the individual and the nation. These were key issues of social concern that gave rise to and which were addressed and proliferated by the various reform movements of the 19th century. The aims and claims of movements such as Grahamism, Spiritualism, Phrenology, and Animal Magnetism were supported by the modes of thinking about human nature that “science” afforded. Embedded in the discourses of humanistic and humanitarian philosophies that aimed to reform the bodies, minds, and institutions of the American people, both reform movements and the new social sciences (closely connected to the former) turned their back to concepts of “religious predestination and political and social subjugation” (Caplan 5). Instead, they endorsed a belief in the “alterability of human nature” (Dewey 106) which was expressed in the doctrines of perfectibility and individualism. Given this emphasis on progress, and the role of the healthy individual in attaining it, it is not surprising that medicine was amongst the first and most aggressive fields of “science” trying to claim expertise in the field of human nature. In their quest for professional and public authorization, physicians could draw on the long tradition of their profession while simultaneously pointing out their dedication to the scientific and reformist zeitgeist. Additionally, they could argue that their occupation directly benefitted people’s well-being and allowed them direct access and insight into one major field of the investigation into human nature – the human body. ← 156 | 157 →

In 19th-century US, however, the medical profession was not unanimously respected. On the contrary, physicians were variously accused of undemocratic and un-American elitism, and denounced as butchers, relying on the heroic treatments handed-down by the famous physician Benjamin Rush, which included purging, leeching, toxic doses of calomel, and the cure-all therapy of blood-letting. The notion of the doctor as a quack who profited from the diseases of the less fortunate was prevalent amongst the antebellum American people since medical practice was largely unregulated. By no means had the medical profession at that point reached what the historian Paul Starr calls “professional sovereignty.” According to Starr, it was not until much later, “that the profession of medicine could comfortably confer upon itself the status of a ‘science,’ connoting theoretical, objective knowledge (as opposed to experiential, intuitive, or subjective comprehension) of Nature” (18).1 Confronted with lack of state support (as licensing laws were mostly repealed in the 1830s) and internal division, medical practitioners saw the need for professionalization to gain the trust and veneration of the public they so coveted (Shryock). A turning point in this process was taking a step beyond the many regional medical societies and establishing the nation-wide American Medical Association (AMA) in 1847.

The AMA saw itself as the gate-keeper for education and practice in medicine, excluded irregular or fraudulent practitioners, and reaffirmed and fortified physicians’ own claim to expertise and authority in areas seemingly apart from medicine. For them, a “true physician was at the same time a social activist and educator” (Grob 5), and medicine irrevocably linked with social policy. This thought was extended when Nathan S. Davis in his address at the first meeting of the AMA proclaimed that “of all the voluntary social organizations in our country, none are at this time in a position to exert a wider or more permanent influence over the temporal interests of our country than the American Medical Association” (qtd. in Davis 19). ← 157 | 158 → However, medicine was not alone in its endeavor to influence the public. In many ways, the adjacent emerging sciences of phrenology, hydropathy, and animal magnetism commanded more trust by the American people than regular medicine, as they appealed towards the preference for individual agency and domestic applicability of their methods.

But the new -isms and -ologies, so thoroughly attacked in Oliver Wendell Holmes’ Homeopathy and its Kindred Delusions (1842) and David Meredith Reese’s Humbugs of New-York: Being a Remonstrance against Popular Delusion, whether in Science, Philosophy, or Religion (1838), actually supported the authority of orthodox practitioners in unforeseen ways, as my research has shown. By fortifying the link between mind and matter and consolidating assumptions of the reciprocal relationship between mind and body, they enabled medicine to extend their claim of expertise from the body into “the other” domain of human nature – the mind. This led to the establishment of a specialized medical branch of early psychiatry that founded its very own organization, the Association of Medical Superintendents of American Institutions for the Insane (now the American Psychiatric Association). Both the organization and its organ of dissemination of knowledge, the American Journal of Insanity (now the American Journal of Psychiatry) persists until today. In linking vice, immoral, or unnatural behavior with mental health, they medicalized deviance and thus supplanted the clergy’s authority with their own. Apart from addressing social concerns over growing numbers of the insane, which they saw as caused by behavior, politics, climate, environment, and heredity, these early psychiatrists increasingly served as expert witnesses on mental health in legal trials.2

2 The Presence of Science in Literature

The colorful and highly competitive medical marketplace was reflected not only in political and legal discourse, but also in cultural productions of the time. The presence of science and especially of medicine in 19th-century literature – poems, essays, novels, short stories – is striking. The growing ← 158 | 159 → interest of the public in scientific matters promised a greater readership for a growing literary market. The expansion of the medical field provided fresh frameworks, vocabulary, and topics for authors such as Edgar Allan Poe. Poe’s mesmeric tales, for example, feature a first-hand description of how to mesmerize people and what can be achieved by it. In “Mesmeric Revelations,” access to metaphysical knowledge is granted to the person under the influence of animal magnetism, and “The Facts in the Case of M. Valdemar” follows a magnetic procedure aimed at arresting death. Poe’s faithful use of emerging scientific narrative techniques as analyzed by Roland Barthes, proved to be so convincing to antebellum readers that they interpreted the story to be a factual account.3 Many writers were highly engaged in debates about the truthfulness and validity of current fads – while Poe and John Neal were avid believers in the potential of phrenology and animal magnetism, Melville used his Moby Dick to ridicule phrenology and physiognomy; and in Fanny Fern’s novel Ruth Hall, the eponymous heroine rejects her phrenological character reading. Nathaniel Hawthorne must also be counted among the sceptics. Hawthorne, amongst many other writers, made frequent use of the figure of the scientist to express his concerns over the dangers residing within this new dedication to unveiling the secrets of Nature and human nature. Both “The Birth-Mark” and “Rappaccini’s Daughter” feature scientists, who each pursue knowledge to an extent where the ones most dear to them die as subjects of their experiments. Hawthorne’s fiction boasts no less than eight examples of the “mad scientist,” who is often a physician such as Chillingworth in The Scarlet Letter. Chillingworth, with his expertise, knowledge, and prying eyes aims to corrupt the soul of his patient Arthur Dimmesdale while pretending to tend to his body. Such stories sparked debates about what counted as good or bad medical practice and bedside-manner. Literary illustrations of doctors’ practice became points of reference by physicians who took them at face value and subjected the literary depictions of doctors to critical ← 159 | 160 → analysis, as Robert Green did for “Dickens’ Doctors” in the Boston Medical and Surgical Journal (926–28).

Literary texts thus engage actively in the construction of the medical profession and show how medico-scientific discourse and its ethical concerns seeped into citizens’ everyday lives. Accordingly, literary texts could either support medical ‘facts,’ complement them (what Robert Scholnick has called conduction), criticize them, or oppose them outright (Scholnick’s term here is resistance), thus reinforcing literature’s claim to a distinct and legitimate domain of knowledge. In this endeavor, antebellum writers received unexpected help from the professions they often ridiculed or vilified in their writing – namely, 19th-century medical practitioners, phrenologists, and early psychiatrists.

3 Physicians Praising Fiction

In 1844, the very first edition of the American Journal of Insanity featured an article called “Insanity. Illustrated by Histories of Distinguished Men and by the Writings of Poets and Novelists”, which was written by the journal’s editor and asylum superintendent Amariah Brigham:

Though both poets and novelists are considered fictitious writers, yet in everything relating to the passions and emotions of mankind, the most celebrated of them, are the most correct of historians. […] The correctness of the writers, in these respects appears to be the result, for the most part, of a wonderful power of observation, or of a kind of miraculous ability. (9)

Brigham explicitly grants novelists the same “power of observation” in diagnosing the “passions and emotions of mankind” that physicians, especially those who specialized in insanity, claimed for themselves. His understanding of the function of literature is twofold: he confers the authority to diagnose, to support or to critique contemporary “truths” about the human psyche to writers of fiction, and he sees literary texts as sources of knowledge that the medical branch he represents can rely on in its work. In doing so, Brigham follows a strategy aimed at validating his own position as physician, scientist, and asylum superintendent.

The same strategy and attitude towards literature can be observed in the Edinburgh-based Phrenological Journal and Miscellany, which functioned as an influential model for American magazines in the genre. In 1823, ← 160 | 161 → twenty years before the appearance of Brigham’s article, the journal introduced its constitutive edition with the following elaboration of the future structure and content of the magazine:

In another department [of the magazine] we propose to institute a course of critical analysis on phrenological principles, of our best and most popular authors […] in which we shall endeavor [sic] to shew that the best writers are the most strictly phrenological; and that, like Moliere [sic] […] without knowing it, these writers owe their popularity to their being phrenological, which is another word for natural. The poets will afford us a noble field, and none more than that “priest of nature” – Shakspeare [sic]. […] We will use the chief excellencies of his work as an exposition of our science [until] we have adduced him as one of our most powerful witnesses (XII)

Here, again, knowledge is ascribed to literary texts and their authors by a scientist. Whether literary writers were aware of their own knowledge or, as this quote suggests, the knowledge was more of a tacit, intuitive nature, both phrenologists and early psychiatrists drew on literature as a source of knowledge for their own sciences. Furthermore, they used literature as a source of validation of this knowledge; they each proposed to use aspects of literary works as an “exposition” of their science, and they wanted to “adduce” authors as “most powerful witnesses.” Thus, with the help of literature – given voluntarily or not – they aimed to legitimize their knowledge, their position, their authority, their very institutions. What is particularly enlightening in these two constitutive articles are the names of the writers who were regarded as being the most fertile and powerful for this endeavor – Molière, Shakespeare, Sir Walter Scott, and Lord Byron. As Marjorie Garber has pointed out, insight into human nature, before shifting to the domain of scientists, had been the task and unique ability of poets and philosophers (17). Men of science frequently made “references to the fiction and poetry of the day and to that of earlier generations. By doing so, they declared an affinity, sometimes of thought, but more often of culture, with respected authors and, indirectly, with their readers” (Otis xix). Alexis Easley notes that “[m]edical periodicals made reference to literary subject matter in a seemingly self-conscious way, as if to present a high-culture rather than a strictly professional perspective on medical science” (158). In short: physicians asserted being professionals in their medical domain by referencing popular and generally accepted literary figures and works who had already questioned epistemological limits of human nature. ← 161 | 162 →

4 Physicians Writing Fiction

Apart from this insistence on cultural capital, medical practitioners resorted to yet another opportunity offered by literature. Since literary writing was not subject to scientific requirements of proof4 it provided and functioned as a unique space in which medical developments and theories were tested as hypotheses, imagined, and extended. Oliver Wendell Holmes Sr., for instance, a Boston Brahmin (a term which he himself coined in his articles for the Atlantic Monthly) was respected for his medical treatises on puerperal fever, but also for his literary abilities. His three novels, Elsie Venner (1861), The Guardian Angel (1867), and A Moral Antipathy (1885) were dubbed “medicated” by his reviewers, due to the diagnostic methods they employed.

In Elsie Venner, published serially from 1859 onwards in The Atlantic Monthly, Holmes explores the theme of original sin, and negotiates the binary of hereditary determinism and moral responsibility. Drawing on his own medical background, he imbues the narrator of the story with diagnostic power and superior knowledge, and includes no less than three medical professionals in the story. He proclaims in his preface, that “a grave scientific doctrine may be detected lying beneath some of the delineations of the character” of the eponymous heroine (vii). Literature, for Holmes, who lectured extensively on the subject, was not only a respectable pastime for a man of his profession and position, but – as Carmen Birkle addresses in a recent article on Holmes –, novel-writing enabled him to apply and extend his medical thinking beyond the limitations of the scientific community (87).

The same appeal motivated Silas Weir Mitchell to taking up the pen. Nowadays, Mitchell is well known for his radical, but seemingly successful “cures” of hysterical women in catatonic states – setting their beds on fire, or undressing while announcing to rape them (Szasz 106) –, and even more so, in his role as Charlotte Perkins Gilman’s attending physician; but he was also a doctor confronted with the horrors of the Civil War. In charge of Turner’s Lane Military Hospital in Philadelphia, he was exposed to what he first called “sensory hallucinations”; gravely wounded soldiers who claimed to feel agonizing pain in limbs that were already amputated. Mitchell was ← 162 | 163 → fascinated by this seemingly irrational condition and conducted further research on the subject. However, instead of publishing his findings in a medical journal, he first framed them within a short story. “The Case of George Dedlow,” published in The Atlantic Monthly in 1866, featured as its main protagonist and narrator a physician who, after being severely injured in the war, ended up a “useless torso, more like some strange larval creature than anything of human shape” (5). While phantom limb pain was not a new phenomenon, having been described by a 16th-century French surgeon, Mitchell has been credited with the discovery and exploration of this condition based on his fictional short story. This says much about the verisimilitude literature was accredited with – a contention that was emphasized by Mitchell’s narrator asserting that he has “dictated these pages, not to shock my readers, but to possess them with facts in regard to the relation of the mind to the body; and I hasten, therefore, to such portions of my case as best illustrate these views” (5).

In their fictional explorations of medical conditions, however, both Holmes and Mitchell equipped their stories with a caveat in case the theories they proposed in literary form were to be falsified. The “scientific doctrine” Holmes described as possibly underlying the character study of Elsie Venner, is diminished in its claim to truthfulness as one that he employed “as a part of the machinery of the story without pledging his absolute belief in it to the extent to which it is asserted or implied” (vii). Mitchell resorted to publishing “The Case of George Dedlow” anonymously, and gave the story a parodic ending.5 Despite these fail-safe strategies, both literary texts were taken seriously by general audiences (who read them as factual accounts) and medical peers (who discussed their medical content) alike. In fact, Mitchell’s account of a soldier suffering from neuralgia inspired many people to take up collections for the pitiful George Dedlow, and some even tried to visit him at the hospital. The reception of this story as a truthful account, so similar to that of Poe’s mesmeric short story “The Facts in the Case of M. Valdemar,” speaks to literature’s multiple functions in the 19th century: introducing and fortifying medical knowledge; purveying its own kind of knowledge (as seen by the interest and empathy towards the personal neuralgic experience that was ← 163 | 164 → generated in the audience through the specificities of literary communication); and notably advancing a physician’s career and self-conception. Mitchell’s “‘literary’ experience […] contributed to his scientific breakthrough” (Journet 87), and Holmes’ didactic literary essays in the Atlantic Monthly established him as a respected physician and gentleman, while fictional techniques enabled both to “explore a phenomenon that [they] could not fully articulate within the scientific paradigms” of their time (87).6

5 The Medical Case Study – A Literary Genre?

What is also interesting to note is that Holmes’ novels and Mitchell’s short story, although decidedly fictional texts, take on the form of medical case studies. While this has been interpreted by some as early attempts to tell the implications of a condition or diagnosis from the patient’s perspective (Bourke; Kline), the medical case study as a personalized and affective account was not uncommon in 19th-century medical writing. In fact, the framework and structure of the 19th-century “medical case study” may in many ways have been derived from its literary predecessor, the character study.7 That physicians and early psychiatrists modeled their scientific “case studies” on examples provided by established authors becomes evident when tracing the development of this methodology from Brigham’s article through subsequent contributions to the American Journal of Insanity. In almost every edition of the journal, descriptions of interesting real cases of insanity alternated with articles in which various asylum superintendents analyzed fictional cases of insanity and praised the authors ← 164 | 165 → for their “correctness” in depicting the causes and symptoms of the individual’s madness, as can be seen, for example, in Isaac Ray’s “Shakespeare’s Delineations of Insanity” (1847):

It is a curious fact, that metaphysicians whose special province it is to observe and analyze the mental phenomena, have shown much less knowledge of mind as affected by disease, than writers of poetry and romance whose ideas are supposed to be the offspring of imagination, rather than a sober observation of facts. No one would look into Locke, or Kant, or Stewart, to find any light on the subject of insanity, but in the pages of Shakespeare and Scott, are delineations of this disorder that may be ranked with the highest triumphs of their masterly genius. (289)

In attributing novelists’ superior knowledge of the human psyche to their talent of observation and the focus on the mind “in the concrete” (289), Ray’s article echoes the beliefs exhibited by his fellow psychiatrist Amariah Brigham.

Physicians and psychiatrists like Ray and Brigham not only openly practiced literary criticism but provided a place for poetry and prose in that they replicated full literary passages that either served to illustrate a point made by the medical professional, or spoke for themselves. Apart from referencing, analyzing, or imitating the depictions by established literary authorities, scientists made abundant use of literary techniques in their treatises, tracts, and articles, employing third-person narrators, and relying on “vivid description, metaphor, and narration” (Cervetti 79). In a time of advanced printing techniques and growing literacy, scientists knew that literature functioned as a point of access for interested lay readers. In order to disseminate their knowledge, advance their reputation, and promote scientific literacy, they did not shy away from publishing their findings in either literary form and/or in the popular press.

6 Medicine and the Literary Marketplace

This seeming transgression of disciplinary boundaries (from today’s view) did seem out of place for neither for readers nor scientists in the 19th century, owing to both the structure of the literary marketplace and barely consolidated demarcation of science, literature, and popular culture. Knowledge, both literary and scientific, was proliferated by magazines and journals, the dominant publication form of the 19th century. In accordance with the broad interests of the public, most magazines were often a hodge-podge of ← 165 | 166 → contributions from any given field, in any possible form. Political essays were followed by poems and political announcements, scientific treatises and moral advice alternated with literary criticism, letters, and travel reports (Haveman; Otis). The titles of these periodicals often reflected this diversity of content, such as Lippincott’s Magazine of Popular Literature and Science or the short lived American Magazine of Useful and Entertaining Knowledge (1834–1837), edited by Hawthorne. Even seemingly specialized journals in the fields of mesmerism, phrenology, or hydropathy paid tribute to broader interests. An excellent example is the aptly titled The American Phrenological Journal and Life Illustrated: A Repository of Science, Literature, and General Intelligence, simultaneously pointing toward the elevated standing of “science” and “literature” in the pursuit of “general intelligence.”

Medical publications proved to be no different. Although by the end of the 19th century, medical periodicals increasingly employed technical jargon, in the earlier decades of the century, even with increased specialization, they took pains to include content and language “as to be accessible to a general educated audience” (Easley 156). The necessity of appealing to the public to further advance both general interest and their authority on matters of the mind and body is reflected in medical periodicals of the time including “book reviews, medical curiosities, sensational narratives, and editorials on hot-button medical issues” (156). As Alexis Easley points out, medical journals thus had much in common with mainstream literary reviews and other magazines of the 19th century (156).

All these examples paint the relationship between medicine and literature as a mutually beneficial one; two fields that were engaged in the struggle for epistemological authority, vitalized by the public’s interest in health and human nature, sharing common subjects, negotiating a field of tension between democratization and professionalism, and united not only in a quest for knowledge but also for national identity and independence from European paragons. The reciprocal influence of medical and literary frameworks that have been laid out here indeed seem to fortify Jane Wood’s belief that 19th-century “medicine and literature looked to each other for elucidation and illustration” of knowledge (2), but also, taking the examples of the Phrenological Journal and Miscellany and the American Journal of Insanity, for mutual legitimization and validation. Since then, literature ← 166 | 167 → and science have apparently parted ways in the quest for knowledge and the methodology employed in obtaining it. Despite the assertions just made in favor of literature’s relevance in knowledge construction and legitimization, the 19th century can also be read as a period in which these trends of relegating literature to the sideline gathered pace.

7 Pathologizing Literature

From mid-century onwards, fronts began to harden between medical practitioners and creative writers as processes of professionalization and institutionalization progressed. In her study of the nervous system in 19th-century literature, culture, and medicine, Justine Murison argues that, especially after the Civil War, more and more literary writers opposed the path adopted by their medical contemporaries who, through neurological and biological theories, pathologized every aspect of human behavior (4). Thus, physicians and alienists proclaimed the need for professional, medical control over physiological and psychological conditions and assumed the sole power of interpretation (6). However, while casting aside the literary imagination as a participant in scientific knowledge production, in an unfortunate but highly fascinating turn of events they made it the object of their study. Expanding 18th-century “debates about the effects of reading on mental health” that “fused moral issues to health concerns” (5), 19th-century medical practitioners began to turn their attention anew towards literary texts – only this time not in search of profound insight attributed to the author’s “wonderful power of observation,” as Brigham contended in 1844, but as symptomatic products of a diseased mind. Insight into the inner workings of the human mind displayed by these texts were explained as having been generated by a pathological drive of their creators. This development can be traced throughout all kinds of magazines, but is especially manifest in editions of the American Journal of Insanity. Examinations of literature persisted after the 1850s, but the approach was turned into an entirely diagnostic one. Literary characters were diagnosed and re-diagnosed according to the newest theoretical framework; additionally, articles like Pliny Earle’s “The Poetry of Insanity” and other references throughout the journal remark upon the supposedly insane’s remarkable talent for creativity and literary abilities, fortifying the long-standing suspicion that there was only a fine ← 167 | 168 → line between genius and madness. Medicine’s focus on “the mad writer,” his or her ailments often being attributed to overly long periods of cramped sitting and overexertion of the mental faculties, was presented as a matter of far-reaching concern, since writers were presumably the “facilitators of national progress” (Easley 169). However, when George Gould, an American medical writer and ophthalmologist, voiced his concern over the mental and physical well-being of domestic writers, he can hardly veil his triumph; in 1903, he declares that “[g]eniuses, the instruments and makers of civilization, depend at last on the medical profession” (760).

8 Summarizing Scientific Strategies

After reviewing the development of the relationship between science and literature in the 19th century through the lens of medical discourse, let me return to the introductory remarks of the Phrenological Journal and Miscellany. For the medical field – and all its adjacent 19th-century branches such as phrenology and asylum medicine – perusing literature “as an exposition of our science” has worked on many different levels. In a first step, practitioners supported the notion of literature as a powerful and authoritative source of knowledge which they could rely on in their own work. Subsequently, by referencing acknowledged authors and equating medical “facts” with those portrayed in novels and poetry, they validated their own position while validating that of literature. Another way in which literature served to “expose” science can be seen by the examples of Holmes and Mitchell who used it as a medium in which they could freely express, test, and extend their medical theories. Likewise, writers of fiction such as Poe and Hawthorne have contributed to the dissemination of scientific theories while being suggestive of the ethical dangers associated with it. Furthermore, medical writers called on literature as a purveyor of techniques with which to convey scientific knowledge in an accessible manner, fulfilling the duty of their profession not only “to discover those individual and social factors governing health,” but also “to disseminate those findings among their fellow countrymen in order that they be put to practical use” (Grob 5). In a final step, through medicalizing literature, pathologizing texts and authors alike, medicine tried to assert its authority as surpassing that of literature when it came to establishing norm and deviance of human behavior, thoughts, and ← 168 | 169 → emotions. I argue that these five main modes of influence – literature as a source of knowledge and mode of dissemination of scientific theories, literature as a medium in which to express medical theories and as a purveyor of technique, as well as finally the medicalization of literature –stand out in their impact on the 19th-century relationship between science, literature, and their negotiation of knowledge and authority. They also constitute a fresh starting point from which one might revisit and contribute to the current debate about the status of literary and scientific knowledge and their possible interaction. Even at a short glance, the modes discussed here seem to be applicable to 20th-century and contemporary discussions of literature and science. Literature still functions as a medium in which to test and imagine, to disseminate and popularize (scientific) knowledge and its ramifications, and as a purveyor of the techniques with which to achieve those objectives, a potential long realized by both science-fiction writers and an ever-increasing number of popular science writers.

Even the final, derogatory step of pathologizing literary texts has provided fertile soil for literature and literary studies. While fiction continued to incorporate, and negotiate psychological theories and concepts within its realm, the same theories offered a new lens for literary scholars through which to read classical and contemporary texts, thus assuming the diagnostic, clinical gaze reserved for physicians and psychiatrists (Foucault). Symptomatic reading, as this practice has come to be called, has thankfully fallen out of favor in recent years, and has been partly replaced with the turn to affect and investigations into literature’s potential for affective knowledge (“George Dedlow” comes to mind). However, the decades-long preoccupation of literary studies with psychoanalytical theories have secured a place for literature in one of the epicenters of investigation into the human mind: in the last decades, psychiatrists and psychologists have reaffirmed Amariah Brigham’s contention that novelists have a unique ability to capture the “passions and emotions of mankind,” that “literature can provide a method of consolidating knowledge about psychopathology” and “facilitate self-reflection” which can prove essential not only for practitioners, but also for patients (Tischler 55).

This short overview of the contemporary applicability of 19th-century modes of interaction reveals the need for further investigations and their potential, but also, that taking a step back in time, and bearing in mind ← 169 | 170 → the origins of the epistemological debate between literature and (medical) science sheds new light on the unique contributions that result from the interaction of the two fields.

Works Cited

Anonymous. “Introductory Statement.” The Phrenological Journal and Miscellany 1 (1823−1824): III–XXXI.

Arnold, Matthew. “Literature and Science (1882).” Selected Essays. London: Oxford University Press, 1964. 208–33.

Barthes, Roland. “Textual Analysis of a Tale of Poe.” On Signs. Ed. Marshall Blonsky. Oxford: Blackwell, 1985. 84–97. [Originally published as “Analyse Textuelle d’un Conte d’Edgar Poe.” Semiotique Narrative et Textuelle. Ed. Claude Chabrol. Paris: Librairie Larousse, 1973, 29–53.]

Birkle, Carmen. “Narrative Praxis und diagnostische Interpretation: Literatur und Medizin in Amerika.” Literatur und Medizin – Interdisziplinäre Beiträge zu den Medical Humanities. Ed. Pascal Fischer and Maricarla Gadebusch Bondio. Heidelberg: Winter, 2016. 79–100.

Brigham, Amariah. “Insanity, Illustrated by Histories of Distinguished Men and by the Writings of Poets and Novelists.” American Journal of Insanity 1 (1844): 9–46.

Bourke, Joanna. “Silas Weir Mitchell’s The Case of George Dedlow.” The Lancet 373.9672 (2009): 1332–33.

Caplan, Ruth. Psychiatry and the Community in Nineteenth-Century America. New York: Basic, 1969.

Cervetti, Nancy. S. Weir Mitchell, 1829–1914: Philadelphia’s Literary Physician. University Park: Penn State University Press, 2016.

Davis, Cynthia J. Bodily and Narrative Forms: The Influence of Medicine on American Literature, 1845–1915. Stanford: Stanford University Press, 2000.

Dewey, John. Human Nature and Conduct: An Introduction to Social Psychology. New York: Modern Library, 1922.

Easley, Alexis. Literary Celebrity, Gender, and Victorian Authorship, 1850–1914. Newark: University of Delaware Press, 2011.

Ette, Ottmar, and Vera M. Kutzinski. “Literature as Knowledge for Living, Literary Studies as Science for Living.” PMLA 125.4 (2010): 977–93. ← 170 | 171 →

Felski, Rita. The Uses of Literature. New York: Wiley-Blackwell, 2008.

Foucault, Michel. The Birth of the Clinic: An Archaeology of Medical Perception. New York: Pantheon, 1973.

Garber, Marjorie. A Manifesto for Literary Studies. Seattle: Walter Chapin Simpson Center for the Humanities, 2003.

Garber, Marjorie. The Use and Abuse of Literature. New York: Pantheon, 2011.

Gould, George. “The Role of Eyestrain in Civilization.” British Medical Journal 2 (Sept 1903): 757–60.

Green, Robert M. “Dickens’s Doctors.” Boston Medical Journal 167.25 (1912): 926–28.

Grob, Gerald N. Edward Jarvis and the Medical World of Nineteenth-Century America. Knoxville: University of Tennessee Press, 1978.

Haveman, Heather A. Magazines and the Making of America: Modernization, Community, and Print Culture, 1741–1860. Princeton: Princeton University Press, 2015.

Holmes, Oliver Wendell. Elsie Venner; A Romance of Destiny. 1861. Rpt. Boston: Houghton Mifflin, 1892.

Journet, Debra. “Phantom Limbs and ‘Body-Ego’: S. Weir Mitchell’s ‘George Dedlow’.” Mosaic: An Interdisciplinary Critical Journal 23.1 (Winter 1990): 87–99.

Kline, David G. “Silas Weir Mitchell and ‘The Strange Case of George Dedlow’.” Neurosurgical Focus 41.1 (2016): 1–8.

Knight, David. The Age of Science: The Scientific World-View in the Nineteenth Century. Oxford: Blackwell, 1988.

Mitchell, Silas Weir. “The Case of George Dedlow.” The Atlantic Monthly. A Magazine of Literature, Science, Art, and Politics XVIII (July 1866): 1–10.

Murison, Justine S. The Politics of Anxiety in Nineteenth-Century American Literature. Cambridge: Cambridge University Press, 2011.

Otis, Laura. “Introduction.” Literature and Science in the Nineteenth Century: An Anthology. Oxford: Oxford University Press, 2009. XVII–XXIX.

Ray, Isaac. “Shakespeare’s Delineations of Insanity.” American Journal of Insanity 3.4 (1847): 289–332. ← 171 | 172 →

Shryock, Richard H. Medicine and Society in America, 1660–1860. Ithaca: Cornell University Press, 1984.

Snow, Charles Percy. Two Cultures and the Scientific Revolution. The Rede Lecture, 1959. New York: Cambridge University Press, 1961.

Starr, Paul. The Social Transformation of American Medicine. New York: Basic, 1995.

Szasz. Thomas. The Medicalization of Everyday Life: Selected Essays. New York: Syracuse University Press, 2007.

Tischler, Victoria. Mental Health, Psychiatry and the Arts: A Teaching Handbook. Oxford: Radcliffe, 2010.

Wells, Susan. “Freud’s Rat Man and the Case Study: Genre in Three Keys.” New Literary History 34.2 (2003): 353–66.

Wood, Jane. Passion and Pathology in Victorian Fiction. Oxford: Oxford University Press, 2001.

1 Starr’s definition of antebellum medical science as relying on “experiential, intuitive, or subjective” knowledge is appropriate. Technological advances in science that enabled “theoretical, objective” knowledge, like microscopy, chemical analysis, and histology did not take root in the US until after the Civil War, and even statistics which was increasingly utilized for establishing medical and social policy was at an early stage and heavily flawed.

2 Isaac Ray, one of the most eminent psychiatrists of the 19th century paid tribute to this development by publishing his Treatise on the Medical Jurisprudence of Insanity (1838), which is commonly regarded as the founding document of forensic psychiatry.

3 In the course of the 19th century, according to Ruth Caplan, “the common language of natural philosophy and humanism” (135) subsided to be shared by medical scientists and laymen, as physicians and psychiatrists increasingly established their own terminology and methodology.

4 Even though those were comparatively lax at that time.

5 During a mesmeric seance, Dedlow is temporarily reunited with his missing legs.

6 Their “clinical fiction” also afforded them a way to negotiate and reconcile the different sides of their profession – for Mitchell, that was the paradox of war-doctors “healing” soldiers in order to enable more death; for Holmes, it was the conflict between a physician’s drive to objective knowledge and the humane emotions that a patient in need triggered. While this tension remained partly unresolved in the texts, both physician-novelists set up their respective medical main protagonists as authoritative figures in the possession of knowledge about human nature as far superior to those without a medical education and thus contributed in their own way to the AMA’s arguments for professionalism.

7 Reading the medical case study as a literary genre, which has been tacitly proposed by Susan Wells in her analysis of the Freudian case study, provides a fascinating opportunity for further scholarship.