Profound Science and Elegant Literature: Imagining Doctors in Nineteenth-Century America (review)

In Profound Science and Elegant Literature, Stephanie Browner, dean of faculty and associate professor of English at Berea College, illuminates a century of profound change in the practice of medicine and the role of the physician.For the first half of the nineteenth century, medicine's claim of authority over the body was tenuous and a physician's profession as much an art as a science. Medical schools were not regulated, and many physicians trained through apprenticeships rather than in classes. Those who studied abroad might have laboratory experience, but not all physicians took that opportunity. Homeopathy competed with traditional medicine, and many people, of all social classes and levels of education, were disposed to try all manner of alternative therapies in their efforts to alleviate pain and cure illness. Physicians themselves were not convinced that science had anything to offer the medical profession; clinical expertise, some believed, was more important. By the time the American Medical Association was founded in 1847, the reputation of the physician, Browner asserts, "was at its nadir" (2). By organizing professionally, traditional physicians hoped they could counter the public's distrust and disparagement and raise the image of the physician, as Browner puts it, to a person "of profound science, elegant literature, polite accomplishments, and virtue" (2).

That goal, Browner shows us, was only partly achieved. By the end of the century, empirical scientific method was no longer contested as a way of investigating the body, and medicine drew upon scientific advances in therapies and theories. As physicians' accomplishments as healers became more visible and consistent, their reputations were enhanced. But their role in American society still proved problematic: their elite status in a democracy, for example; their close work with marginalized groups, such as immigrants, African Americans, and women; and the scope of their authority into areas other than medicine, such as social unrest, political dissension, and domestic policy. For physicians, the nineteenth century was a period of increasing professionalism and continual redefinition. Browner focuses on the social construction of the physician's role as a healer, a scientist, and, more generally, a figure of authority, and she asks how fictional portrayals of physicians both reflected and helped to define that role.

Browner turns to Nathaniel Hawthorne to examine the physician's role early in the century, when investigations into nature seemed fraught with danger and trespassing into the body was especially worrisome. Hawthorne's "The Birth-mark" and "Rappaccini's Daughter" portray scientists—and by extension physicians—as menacing. These stories reflect cultural anxieties about physicians' power to probe the body, and even the mind, to unearth nature's secrets. At the same time as they reveal suspicion about medicine's powers, such stories also reveal a deep attraction to envisioning and exploring the thrilling depths of the pathologized body.

By midcentury, in the short stories of popular magazines, the physician was a more temperate and benign figure, often emerging as an authority not only in areas of health and disease but in other areas as well, dispensing wisdom, showing good taste, behaving with cultural sophistication. Though such a portrayal emphasized the class difference between physicians and many of their patients, the elite physician could still help to stabilize a society that seemed prone to disorder and dissension caused by immigration, poverty, urbanization, and the changing role of women in the home and the marketplace.

Like medicine, the profession of nineteenth-century fiction writing also had a varied group of practitioners, and Browner focuses as closely on canonical writers such as Hawthorne, Herman Melville, William Dean Howells, and Henry James as she does on Victoria Earle Matthews, Rose Terry, Calvin Wheeler Phillio, and a host of other authors whose reputations did not outlast their lives. Her sources, both primary and secondary, are prodigious, and her reading of the fiction is carefully nuanced.

Two especially interesting chapters focus on short fiction in such magazines as the...