In this article, I argue that we should consider the medical case narrative as an “epistemic genre.” I suggest that historians of knowledge (including medical knowledge) should draw a distinction between “epistemic” and “literary” genres, and that the medical case narrative belongs to the first group, that is, those kinds of texts that develop in tandem with scientific practices. I also argue that the history of the medical case narrative should be studied in a long-term perspective. In general, the focal point of the historiography on the medical case narrative has tended to gravitate around the late eighteenth and nineteenth centuries, with only cursory attention to earlier periods and no attempt to reconstruct the long-term lineaments of the story. I believe that this modernist focus has a very serious flaw, as it ignores the presence of a vast literature of case collections in pre-modern medicine. I believe that we need to trace the history of the medical case narrative as a genre that evolved over a very long period of time, from antiquity to modern medicine. For this purpose, I adopt the approach that literary scholar Franco Moretti has called “distant reading,” that is, a focused attention to the long duration of a genre within a culture as well as its variations across cultures.
What do we see when we look at the long-term development of the medical case narrative? Distant reading suggests, at first sight, that the genre appeared in embryonic form in antiquity, with the Hippocratic Epidemics, but also that it disappeared for long periods of time, to emerge again, in new form and with new vitality, in the late Renaissance. Most interestingly, distant reading also suggests that the evolutionary dynamic of the case narrative was closely intertwined with that of two other fundamental epistemic genres, the recipe and the commentary. Here, I examine in particular the association between case and commentary.