Out of the Dead House: Nineteenth-Century Women Physicians and the Writing of Medicine (review)

Rhetoric, the "art of persuasion," really discourse about discourse, has a rich tradition that derives from the Sophists, Aristotle, Cicero, and their successors in the medieval, early modern, and Victorian eras. Today, literary theorists have borrowed the methods and vocabulary of rhetorical analysis—and rhetoricians have borrowed the methods and vocabulary of literary analysis. Susan Wells identifies herself by trade as a rhetorician and literary scholar. Her new book, Out of the Dead House, a hybrid of rhetorical analysis and medical history, is a richly detailed exploration of the writings and careers of nineteenth-century American women physicians. We are accustomed to seeing rhetorical analysis applied to privileged texts—fiction, poetry, high political discourse. Here, it is smartly applied to nonprivileged historical texts: newspaper reportage, commencement lectures, doctoral dissertations, occasional speeches, and scientific papers.

Wells writes from a feminist perspective: her methodology depends on a generously empathic identification with her subjects. The first wave of women entering the medical profession had to figure out how to operate in a world where gender performance and professional performance were at odds. Critics, both inside and outside the profession, argued that a woman, by virtue of her delicate constitution, could not adequately meet the strenuous emotional and physical demands of doctoring—or, if she did, could not morally, culturally, socially, or sexually perform as a woman. Some feminist scholars have concluded from this that nineteenth-century medical practice—the very language of scientific medicine—was intrinsically masculinist. A truly feminist healing practice would have to come from outside science and the scientific professions. Wells argues differently. Her lady doctors tended to make the same therapeutic choices as men. But in taking on the role of physician, a role traditionally coded as masculine, Wells's lady doctors adapted and revised the discursive vocabularies available to them, and in some cases invented new ones. In their writings and practice, they recoded medicine as feminine, oppositional, or gender-neutral—and recoded themselves as well.

The plan of the book is a series of interlinked essays. Three chapters focus on the careers and writings of individual woman physicians—Ann Preston, professor of physiology and later longtime dean at the Woman's Medical College of Pennsylvania (WMCP), the voice of the female medical establishment; Hannah Longshore, an early graduate of WMCP and sister-in-law of the founder, who eclectically blended water cure, homeopathy, and spiritual healing with regular practice, a stance that put her at odds with the institution she loved; and Mary Putnam Jacobi, author of The Question of Rest for Women during Menstruation (1876) and many other publications, who famously succeeded in getting recognition from the male medical establishment. Three other chapters deal with rhetorical performance on a collective level. One explores the development of a distinctive female style of empathic medical conversation and interaction with patients (the taking of "heart histories"). Another focuses on differences between medical theses written by women and by men (women tended to employ satire and to be critical of the medical profession). A final chapter deals with women's controversial entry into the clinic and dissecting room, where they were confronted with the body exposed and where they confronted men with the possibility of male exposure to the female gaze.

Throughout, Wells carefully attends to the problems women faced in entering a domain originally scripted by and for men. In writing medical discourse, female physicians could "cross-dress," that is, adopt a masculine-identified rhetorical style. Or they could employ a feminine-identified empathic tone and holistic approach to healing and a maternal nurturant approach to doctor-patient relations. They could write in the "register of health" and prevention and morality, a medical realm that seemed appropriate to women...