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

Susan Wells, a professor of rhetoric, relates two important themes in this provocative book: medical talk and women's work in medicine in the nineteenth century. She analyzes the writings of several early graduates of the Woman's Medical College of Pennsylvania, and in the process describes the medical scene in Philadelphia, one of the more hostile places for the women who attempted to study and practice medicine in the decades after the Civil War. By a close reading of what Ann Preston, Hannah Longshore, and Mary Jacobi said and wrote, we gain a rich picture of the medicine and medical education of the time. These women, Wells maintains, had a strategy she compares to cross-dressing: they wrote as male, even though they did not present themselves as men.

Although historians such as Regina Morantz-Sanchez and Judith Leavitt have shown that little difference appears between the prescribing patterns of male and female physicians, this is not true for their medical discourse. Wells shows that medical talk does have gender determinants, although she is not the first to do so. She reminds us that in stark contrast to today's brief conversations between doctors and their patients, in nineteenth-century practice conversation was often protracted and was usually the key element in the medical encounter. She not only distinguishes a gendered discourse, but can stipulate whether it is in a male or female voice, or in a voice that is feminine but masquerading as masculine in order to gain greater acceptance for what is being said. We can gain here a rich understanding of what was being said or written and what was expected by the auditor or reader.

Wells describes what she calls "heart history," especially as found in the writing of Harriot Hunt of Boston: these were stories usually told by women patients, and relayed in the context of a moral tone. The author of these writings was much more likely to be a woman physician, who was supposedly more interested in the experience of the patient's illness than a male physician, who would be more concerned with the material aspects of the disease. Thus this book contributes to our understanding of the role of medical talk in the medical professionalization that occurred in the later decades of the nineteenth century. One episode of talk that the author describes well is the 1869 jeering incident at the Pennsylvania Hospital, when male students nearly proceeded to riot after witnessing patients being demonstrated before a mixed-gender student audience. This incident, which caused much discussion in newspapers and medical journals of the time, serves as a vivid example of the problems still faced by the women medical students nearly two decades after the founding of their separate school. Wells reminds us that the medical amphitheater may be seen much as theaters more generally: in the latter, the unescorted woman was also believed to be out of place.

This book is an example of the growing field of medicine and literature, an exciting development of the last two decades. Medical historians have much to learn from our literary colleagues. But when scholars cross disciplinary boundaries, should they not be held to the standards of accuracy of both fields? Apparently no one with wide knowledge of nineteenth-century medicine was involved in the vetting of this book. It is unfortunate that in the first part there are so many errors that historians may be too annoyed to read further, which would be a shame. Wrong names are but minor errors, such as Keith for Kenneth Ludmerer, George for Edward Clarke, Sachs for Sacks, and Hyman for Wyman. More serious is that Wells mentions the founding of the AMA in 1846 and then tells us of its "dazzling success" (p. 7); that success, as is well known, was very...