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

The literature on women in American medicine and science has grown substantially in the past quarter-century. But Out of the Dead House is, to my knowledge, the first book-length study by a rhetorician of the “registers,” tropes, and other rhetorical strategies employed in women physicians’ writing. Susan Wells, a professor of English and a rhetorician by training, has given us a close reading of the senior medical theses, journal articles, commencement addresses, celebratory speeches, and even fiction of several of the pioneer generation of women physicians in the United States. Her main subjects include Drs. Marie Zakrzewska, Rebecca Lee Crumpler, Harriot Hunt, Ann Preston, Hannah E. Longshore, Mary Putnam Jacobi and other, lesser known figures. Wells uses their work to understand the ways in which they performed the role of woman physician through their writing.

Despite its small size, the sample included here represents a variety of careers and genres of writing. Wells’s subjects range from unabashed homeopathy (Longshore) to intransigent orthodoxy (Ann Preston), and from general practitioner (Crumpler) to clinician-researcher-educator (Mary Putnam Jacobi). Such diversity supports the first of her main contentions, namely that there was no one woman’s “voice” in nineteenth century medicine. (Compare, for example, Crumpler’s Medical Discourses of 1883, the only known medical book by a nineteenth-century African American woman and a book of general medical advice, to Jacobi’s medical journal articles detailing her latest pathological investigations.) Second, Wells sets out to demonstrate through their writing how women physicians “made sense of their anomalous gender position” (p.12). In short, she wants to show how women’s medical writing performed an essentially twisted feat of gender, representing the authors as women medical scientists. Finally, she convincingly demonstrates that the language and practice of medical science were familiars—not exotics—to women physicians.

Wells grounds her approach in the work of gender theorists such as Judith Butler and Rosi Braidotti. For historians, the jargon level may be a little high. The usual suspects—performativity, habitus, and the like—pale beside terms of rhetorical art such as “deictic,” “proleptic,” or “paraleptic.” But such language provides the underpinning for the work at hand, namely, an attempt to show how women physicians performed their hybrid status in and through their writing. Wells approvingly quotes Braidotti, that “In feminist theory one speaks as a woman, although the subject ‘woman’...is not an essence defined once for all but rather the site of multiple, complex, and contradictory sets of experience (p. 71).” As agents and speaking subjects, women physicians writing medicine do gender but also are gendered by their readers. Wells is quite illuminating on the various gender performances carried out by these authors, but less so, necessarily, on the ways in which their writing was received.

What were some of the ways to write as nineteenth-century women-who-are-physicians? Wells makes the useful distinction between the register (roughly, a genre’s characteristic “voice”) of “health” and the register of “medicine.” Writing in the register of health, a man or woman wrote of matters of personal and public hygiene in language fit for the general public; in the register of medicine, one addressed colleagues about disease etiology and therapeutics, pathology, the body, in short about matters not fit for frank public discussion. The register of health, to the extent that it implied a public mode of address, had not always been gendered feminine. But by the time Elizabeth Blackwell graduated from medical school in 1849, women such as Catherine Beecher were busily subverting the genre, turning it to feminine prophetic purposes.

But the register of medicine was another matter. To speak of medical matters was to risk a reputation for vulgarity, and few women dared do so without the protective cover, the license so to speak, of a medical degree. Women writing medicine, as Mary Putnam Jacobi and many others did, required what...