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  • Symptomatic Subjects: Bodies, Medicine, and Causation in the Literature of Late Medieval England by Julie Orlemanski
  • Aylin Malcolm (bio)
Julie Orlemanski, Symptomatic Subjects: Bodies, Medicine, and Causation in the Literature of Late Medieval England. Philadelphia: University of Pennsylvania Press, 2019, x + 333pp. $69.95 cloth.

The events of 2020 revealed the importance of effective communication in healthcare and the potential for epidemics to inspire new narrative projects, concretizing decades of research on the intersections between literature and medicine. Though its publication anticipated these developments by several months, Julie Orlemanski's Symptomatic Subjects is an important contribution to such discussions and to the study of premodern medicine, a field generally dominated by historical methods. Orlemanski offers a sophisticated new perspective on the entanglements of literature and phisik—a Middle English term that includes both academic approaches to healing and more diffuse local practices—in late medieval England. Her deliberately anachronistic use of "symptom," which she defines as "a somatic disturbance that … provokes interpretation," speaks to the parallels between diagnosing a body and analyzing a text; both projects require one to interpret visible signs in the context of larger semiotic systems, a fact recognized by many medieval writers (p. 16). As her title suggests, the book also considers what Orlemanski calls "embodied subjectivity," characterized by the tension between physical susceptibility and the medieval emphasis on free will (p. 2). Orlemanski is particularly interested in individuals who reflect on their own bodies or pathologies, thereby addressing the "gap between one's materiality and one's experience, or between having and being a body" (p. 3).

While Symptomatic Subjects will appeal most to those specializing in the late Middle Ages, its rigorous engagement with both literary criticism and the history of medicine is likely to interest a range of scholars. An evident strength of the book is its careful close readings, which address canonical texts (e.g., Geoffrey Chaucer's Knight's Tale) alongside others that are often overlooked (e.g., John Lydgate's "Dietary;" Robert Henryson's "Sum Practysis of Medecyne"). Many of these textual interpretations include studies of individual manuscripts; in particular, the Wound Man (a standard diagram of the various injuries that a physician might treat) in Wellcome Library MS 290 serves as an emblem of Orlemanski's project, embodying her interests in the relationships between particulars and general causes, as well as the tension between human agency and vulnerability. Each text or object is contextualized with generous references, such that the reader trained in a different field will likely require no further notes. Indeed, while the book has a clear overarching narrative, it often recapitulates essential information in multiple chapters; each chapter might therefore be read independently without additional context, a welcome feature in the age of digital downloads. [End Page 231]

Structured as four parts of two chapters each, Symptomatic Subjects progresses from an overview of medieval medical knowledge to its effects on literary genres, plot, and voice, with a brief coda on the early modern afterlives of phisik. Orlemanski begins by surveying medicine in late medieval England, where the absence of formal medical institutions produced a diverse constellation of beliefs and practices. Chapter two delves more deeply into four aspects of phisik: the etiological schemata through which physicians ascribed medical conditions to causes, the decentralized and heterogeneous character of medical authority, the tendency for physicians to read bodies as signs with identifiable meanings, and the relationships between content and layout in medical manuscripts. Both chapters offer not only useful information about medical practices, but also perceptive analyses of medical writing, as Orlemanski applies her considerable critical skills to texts not often read as literature.

The next two chapters examine satire, which often criticized the obscure jargon and earthly materialism of medical texts, and exempla, or short anecdotes illustrating moral principles, a very common narrative form during the late Middle Ages. The fourth chapter's comparisons between exemplary narratives and medical case studies are especially enlightening, providing clear evidence of the fluid relationship between medieval literature and medicine, and thus of the importance of Orlemanski's work. Central to this chapter is Orlemanski's notion of the "etiological imagination," or the creative process of envisioning causation with...


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pp. 231-233
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