Mark Twain's Medicine Show

K. Patrick Ober. Mark Twain and Medicine: "Any Mummery Will Cure." Columbia: Univ. of Missouri Press, 2004. Pp. xix + 362. $47.50.

In a 1901 North American Review essay occasioned by the appearance of Mark Twain's books in the uniform editions that signaled the beginning of his canonization as a literary writer, Twain's friend and future biographer William Dean Howells tried to pinpoint the traits that had shaped Twain's art. Howells, longtime editor of the Atlantic Monthly and himself a novelist of a more conventional stripe than Twain, fashioned his portrait of the artist from a string of paradoxes. Twain was a humorist, but his humor masked a gravity that invited the literary lionization he was then undergoing; he was at once a Westerner and a Southerner, a writer shaped simultaneously, that is, by the idea of the frontier and the fact of slavery; he wrote "boys" books, but his language was nuanced in a way that struck Howells as feminine. Searching for language to sum up these paradoxes, Howells eventually left aside syntax and settled on a series of adjectives to describe Twain and his work: "chaotic, ironic, empiric."

None of the terms are surprising. The first two, chaotic and ironic, describe a Twain most of his readers are acquainted with—the author who can give us the thick irony of, say, "The War Prayer," and whose plots may jump the track like the last chapters of Huckleberry Finn and strike out for uncharted narrative territory. But familiar as such accounts of Twain may be, it is the last of the three terms, empiric, that best comprehends the conflicting impulses Howells sensibly perceived to be his friend's authorial strengths. Twain does seem, more than most of his contemporaries, to have worked by an empirical method. He persistently confronted the conventions of his day on the evidence of his own observations. But in characterizing Twain as empiric, Howells, who knew the man's private eccentricities well, must also have been thinking of an earlier use of empiric to describe a susceptibility to medical quackery.

Howells's personal acquaintance with the more credulous side of Twain's nature stretched back decades, and when he came to write of their friendship in My Mark Twain (1910), he would link Twain's credulity directly to medical matters. Musing on the strains of skepticism and gullibility that came together in Twain, Howells marveled at how he "was apt, for a man who had put faith so decidedly away from him, to take it back and pin it on some superstition, usually of a hygienic sort." What Howells makes clear in the biography, and seems to have intuited as early as the 1901 essay, is that the collection of beliefs and impulses that molded Twain into the writer we know are nowhere more observable than in his unusual relationship to health and the practice of medicine.

The notion that something central to Twain's character is revealed in his attitude toward medicine became something of a commonplace after Howell's biography appeared, but it has taken nearly a century fore someone to produce a book-length study of the idea. In Mark Twain and Medicine: "Any Mummery Will Cure," K. Patrick Ober, Professor of Internal Medicine at Wake Forest University School of Medicine, does just that. Like Howell's earlier description of Twain, Ober's study follows its subject onto terrain fraught with paradoxes and inconsistencies. But Ober has the advantages of a 20th-century knowledge of medicine and a broader perspective on Twain and the world that made him. The result is a fascinating view of Twain's—and one might say the nation's—complicated and often contradictory views on health, disease, and medical practice.

Even casual readers of Twain are likely to have noticed that matters of health...