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EPILOGUE TOWARD A NEW HISTORICIST METHODOLOGY A CENTRAL CONCERN of this book has been to show: first, how clinical medicine constitutes a certain systematic view of, and way of talking about, its object—the pathologically embodiedperson ;andsecond,how,andwithwhatconsequencesbothfor aestheticsandideology,novelistsimitatethismedicalpraxisastheygo about their work. My premise is that the disclaimers of scientific cliniciansandliteraryrealistsnotwithstanding ,neitherlineofworkisoccupied with a simple act of transcription or prescription, and neither looks at reality with an innocent eye. Both diagnosis and description, prognosis and plotting, involve not only what Donald Fanger, speaking of Balzac, calls a “principled deformation of reality,”1 but its principled formation. To see with a medical eye means invoking, however tacitly,acomplicatedsystemoftechniques,conceptualconfigurations, presuppositions, and protocols of interpretation that enable one to take signs as symptoms and thereby to impose a particular order on reality. It is this discursive system of clinical pre-scriptions, and its deployment through medical and literary fields, that I have tried to elucidate . Beyond that, however, the results of the present detailed study of this particular literary/discursive nexus have a number of implications for the more general question of how one can situate literature in history. Thefirstisthatthehistoryrelevanttoliteratureincludesthehistory ofscience,thatthesciencesareaculturalphenomenonprovidingpart of the cultural basis for literature just as other kinds of intellectual activitydo.Thisisnot a very daring suggestion, tobesure. In thinking ofmedicine inparticularas a culturally implicated ratherthan purely scientific practice, I am by no means alone. But the archaeological method I have used to analyze the cultural resonance of this practice distinguishes my book in severalways from other recent cultural studiesfocusingonmedicine .Theseworksincludefascinatingdiscussions of such medical topics as menstruation, the use of chloroform, the etiology of hysteria, and the symptomatology of degeneration, as well as critiques of the egregious bias against women enforced not only by particularmedicalmenlike Acton,Maudsley,orWeirMitchell,butby the medical profession as a whole.2 Above all, the criticism of these topicshas emphasizedmedicine’s participation inideology,focusing 176 EPILO GUE attention on the operational presence within the medical context of gender, class, or racial oppositions—oppressive ideological differencesthatmedicalideasreinforceorrestabilizeaspathologizedstere otypes .3 An archaeological analysis, on the other hand, although not denying the existence and salience of cultural axes such as male/femaleorwhite /blackinmedicalthought,cutsthroughthatthought in a different way. Archaeology seeks to identify in medical (or any other) discourse a set of cognitive assumptions that have their own consistency, a consistency irreducible to that of a stereotyping or scapegoating mechanism, and irreducible as well to the axes along which such mechanisms move.4 Onewaytoreconcilearchaeologicalandideologicalmethodswould be to seek an axis of discrimination as pervasive as gender, race, or class, but peculiarly the province of archaeological criticism. In the archaeology of medicine, such an axis might be that of “pathology,” becausetheproductionofmedicalstatementsdoesthework,aboveall, of differentiating the healthy from the sick. But the notion of an axis ofoppositions,whichseemsappropriatefortheideologicalanalysisof race, gender, and class, does not quite capture the way in which medicalthoughtcarvesupconceptualspace .Althoughpathologycertainly entailsadistinctionbetweenthenormalandtheabnormal,therhetoric of pathology does not divide already given subjects from each other(separatingblackfromwhite,menfromwomen,bourgeoisfrom proletariat) so much as it generates a profusion of pathologized persons within and across all these groups. Toreduce pathology to difference (to paraphrase the title of Sander Gilman’s important book on thattopic)istoriskobscuringthecomplexityofthisintellectualoperationandthe enormousdispersion ofhistorically specific categories of self it yields. For example, one can certainly analyze hysteria in ideological terms as a misogynistic medical concept, as feminist critics as diverse as Cixous and Ehrenreich have done; but as I point out in my readingofMadameBovary,hysteria mayalsobeunderstoodas a condition to which not only women but men as well are susceptible, and which signifies a more wide-ranging medicalization of the embodied person (and not only of the embodied woman) that is occurring both withinFlaubert’snovelandwithinhisculture.5 Theparticularmedical discourse that defines the hystericized feminine body also brings into focus not only hysterics, but monomaniacs, cretins, club-footed men, and many other pathologized individuals; and this is accomplished not through a monolithic mechanism of repression(patriarchal, capitalist , racist, and so on) working along a single axis, but through a nuanced, multiply-directed variety of diagnostic, etiological, and nosological techniques. T OW ARD A NEW HIST ORICIST METHO DOLO GY 177 These techniques, we have seen, are orchestrated and given consistency , translated into knowledge, by a medical rhetoric whose quasipoetic quality we risk overlooking as well, if we focus merely on the stereotypingofrace,class,andgenderidentities.Thatartisticcapacity is perhaps more clearly displayed in medical statements less blunt or controversial than those that invite criticism from the sharpness of their stereotypes. Take for example the following textbook description , by a physician whom the medical historian M. Jeanne...


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