Medical Progress and Social Reality: A Reader in Nineteenth-Century Medicine and Literature (review)

Furst, Lilian R., ed. Medical Progress and Social Reality: A Reader in Nineteenth-Century Medicine and Literature. Albany: State U of New York P, 2000. Pp. 314. ISBN 0-7914-4804-5

Medical histories typically highlight the immense progress made in the field of medicine from its origins to the present day. The nineteenth century is presented as especially eventful, and such inventions and discoveries as the stethoscope, anes-thesia, asepsis, and antisepsis are credited with revolutionizing the practice of what was once deemed more "art" than "science." As a corrective to the impression of an unchecked march forward that such histories convey, Lilian Furst has assembled literary selections from the work of twelve different authors, sandwiching them between the Hippocratic Oath at the beginning of the book, and Daniel Cathell's guide manual for physicians (Book on the Physician Himself), at the end. The per-spective that emerges from such an anthologizing of texts dealing with medical practice is far more nuanced than that put forth by conventional histories, for if the histories chronicle the "medical progress" evoked in Furst's title, it is (perhaps ironically) in fiction that one is best able to get a firm grasp of the "social realty."

Limiting her focus to the second half of the nineteenth century, a period during which medicine was transformed "from a largely speculative endeavor into a discipline governed by scientific principles" (xii), Furst introduces her texts with a useful summary of nineteenth-century medical history, emphasizing the shift from humoral medicine to germ theory. In this section, she discusses the birth of path-ological anatomy, the development of various instruments that probe the human body, and the inventions (anesthesia, antiseptics, etc.) that changed surgery from a probable rendezvous with death into a relatively safe enterprise. Having prepared her reader by this contextualization, Furst then moves on to the Hippocratic Oath and its descendents, and from there to the literary passages which provide "a different, essentially personal, perspective" (xi). The selection, presented in roughly chrono-logical order, includes texts from American, English, French, German, and Russian authors of the late nineteenth and early twentieth centuries. In all but two cases, the texts are excerpted from longer works. Two short stories ("The Steel Windpipe," by Mikhail Bulgakov, and "The Doctors of Hoyland," by Arthur Conan Doyle) are reproduced in their entirety. Other authors represented are Anthony Trollope, Eugène Sue, Gustave Flaubert, George Eliot, Robert Louis Stevenson, Sinclair Lewis, Thomas Mann, George Moore, Somerset Maugham, and Sarah Orne Jewett. Each author's work is introduced by an informative essay that gives a brief sketch of the author's life, summarizes the passages selected, and provides relevant historical details. These essays conclude with a series of questions that open onto wider issues in medicine and would for this reason be useful stimuli to classroom discussion. A list of additional historical and literary readings is provided in lieu of a bibliography.

As a respected comparatist and a well established authority on fiction dealing with medical subjects, Lilian Furst is a reliable guide both to the literature of the mature nineteenth century and to its medico/historical context. Her anthology is well balanced, including both male and female authors, and featuring both flattering and unflattering portrayals of the physician. Among the issues raised by the readings are the ambiguous role of the early hospitals, the striking change in the doctor-patient relationship that occurred in tandem with technological advances, the precarity of the physician's position in nineteenth-century society, the ethical dilemmas faced by researchers, the risks of pre-Pastorian surgery, the commercialization of medicine, the relative status of various medical degrees, and the difficult entry of women into the profession. Taken together, the literary passages reflect the discouraging disparity between theory and praxis. If widespread skepticism derived at least in part from the lengthy delays...