Beyond the Body: The Boundaries of Medicine and English Renaissance Drama (review)

This book explores the boundaries between medicine and drama in history, offering an "externalist medical history within a literary apparatus" (p. 10) to identify how group identities of medical practitioners took shape and coherence in early modern society. Five case studies each examine one particular "group": drug-sellers, women practitioners, surgical healers, physicians, and patients. Each dramatic "type" depicted is seen to reveal the tensions that exist in society: the drug-sellers whose roles are shown in terms of economic change and resistance; the female practitioners who have a complex relationship with authority; the duality of surgeons who look within the body yet also take care of its externals; the paralleling of physicians and princes through a study of the College of Physicians—like princes, physicians were caught between forces that centralized power and those that diffused it—and "popular diagnostic codes" revealed by the constitutional shenanigans in Twelfth Night.

Using the metaphor of the stage throughout, Kerwin begins his study with an analysis of medical historiography as a complex drama, in which "externalist" historical narratives need to displace the role of the "Heroic Doctor" so familiar to Whig histories, and introduce such roles as "Poverty and Cultural Conservatism" and "Cultural Obsessions," the latter of which includes "the whole gamut of hopes and fears [that] frame the meaning of diseases and assign roles to the ill and their healers" (p. 9). Where this book works well is in Kerwin's close reading of literary texts, as informed by medical history. His reading of Twelfth Night, for instance, shows how a much more nuanced interpretation of Malvolio's behavior comes from a thorough understanding of humoral theory and its contemporary social usage. Here, and in other places, Kerwin connects medical, religious, economic, and literary narratives in ways that have often been neglected. His interpretation of the various roles of women as caretakers of the workings of the body, rather than as purely healers of the soma, is rich and provocative. Yet I am unconvinced by the bigger picture that he strives to draw, particularly in his attempt to broaden out into medical historiography more generally, and to provide commentary on current medical practice.

Kerwin's basic premise—that medical knowledge and practice is not an inevitable or accidental aspect of society, but a construct that involves and plays into broader social beliefs and concerns—is not in question, though his argument lacks any systematic use of sociological theory or sustained critical analysis. There is nothing particularly new about viewing society as "a stage of instability and competing voices," and medical boundaries as "continually shifting" (p. 15). The claim that "all the world's a stage" has been made, rather more effectively, in dramaturgical theory since the 1960s, most famously by Erving Goffman in his Presentation of the Self in Everyday Life (1959). And historians have long acknowledged the diversities and complexities of both medical theory and medical practitioners. In this context, Kerwin acknowledges that the parameters he sets for definition and inclusion in his groups of practitioners are arbitrary and potentially problematic. Yet so too are his three "categories" of narrative: that of practitioners (otherwise labeled "science writing"), that of patients (known as "illness narratives"), and that of "the cultures in which practitioners and patients meet" (pp. 4–5). To elide the stories of doctors with those of "institutional medicine," and to impose boundaries between the narratives of the healers and the sick in this way, surely inverts the dynamic social and literary politics that Kerwin seems to recommend. Equally, to suggest that modern medical practice is so uniformly prescriptive and removed from other facets of life that "still, medical culture needs a fool" in the Malvolian sense (p. 231) seems out of keeping with his avowed polemic that "the boundaries of medicine ultimately are as unstable as the boundaries of culture, in all its transactions and competitions...