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Literature and Medicine, Volume 31, Number 1, Spring 2013, pp. 17-39
(Article)
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DOI: 10.1353/lm.2013.0005
Noelle Gallagher
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Some of the poets and prose writers working between 1660 and
1760Tobias Smollett, Oliver Goldsmith, John Arbuthnot, Samuel Garth,
Richard Blackmore, Mark Akensidemight have had a personal incentive to correlate medical and satiric practices, because they themselves
had been trained as physicians or surgeons. Yet many writers not
actively involved in the practice of medicine also sought to explore
the changing relations between medicine and literatureand especially
between medicine and satire. Some such explorations were acts of
tribute (Popes 1735 Epistle to Arbuthnot is one notable example); but
the eighteenth century also saw the production of an extraordinary
array of satiric attacks on mercenary, ignorant, or pretentious medical
practitioners. From the pompous Latinity of Fieldings surgeon in Joseph
Andrews (1742) to the farcical forceps work of Sternes Doctor Slop in
Tristram Shandy (1759), the practices of professional medicine remained
a favored target among eighteenth-century satirists. For writers like
Sterne and Fielding, the satire-as-medicine commonplace was not just
a means of prescribing harsh Remedies to an inveterate Disease: it
was also a means of exploring wider cultural concerns that affected
the practices of both medicine and satire.
This essay will survey some of the uses and implications of the
satire-as-medicine commonplace in British literature between 1660 and
1760. In examining several of the similaritiesand differencesbetween
satiric and medical theory, I want to suggest that Restoration and earlyeighteenth-century satirists defined their genre strategically, identifying
satire as a therapeutic practice sometimes in alignment with, and
sometimes in opposition to, the work of contemporary medical practitioners. Ultimately, I suggest that Restoration and eighteenth-century
satirists used the satire-as-medicine commonplace not only to defend
potentially offensive or libellous statements, but alsoand perhaps
more importantlyto engage with a number of debates relevant to
both literary and medical practice, including the clash between the
ancients and the moderns, the divisions between the arts and the
sciences, and the shift from a patronage-based system of production
to a commercialized marketplace.
Healthy Body, Healthy Mind: Disease and Morality 16601760
The comparison between satire and medicine was only one of
several commonplaces by which Restoration and eighteenth-century
critics defined satiric literature.4 The medical model had maintained
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for similar reasons, and in similar ways. The growth of commerce, for
example, had strongly affected both the medical and literary worlds:
an expanding array of medical practices and practitioners emerged to
meet the increasing demand for treatment.54 Equally, literature was
becoming a profitable line of business, with writers-for-hire catering
to the demands of a larger, and more diverse, body of readers.55 As
commercial writers and medical professionals exploited the increasingly
lucrative markets for their wares, satirists attacked prominent figures
in both fields for subjugating their professions higher moral purposes
to a selfish desire for material gain.
In works like Garths Dispensary (1699), for example, the satire-asmedicine commonplace provided a means of critiquing both mercenary
writers and for-profit physicians. Written in the context of the Royal
College of Physicians decision to open a free dispensary for the poor,
Garths poem dramatized as a mock-epic battle the conflict between
two opposed camps of college members: the Society Physicians,
who supported the creation of the dispensary, and the Apothecaries
Physicians, who opposed the venture as a threat to their profits. In
the preface to the 1718 edition of the poem, Garth explicitly identified
his satire as treatment for a profession that had itself grown sick,
and the poems speaker repeatedly attributes the current dis-ease within
the College to a shift from altruistic to commercial medicine.56
Writing as both a physician and a satirist, Garth questioned the
commercialization of literature as well as of medicine, and the poem
frequently aligns physicians engaged in Mercenary Projects with
hack writers.57 Not only do the Apothecaries Physicians count a hack
poet (Blackmore) among their number; they also make their money, at
least in part, by scribbling. As the villainous Mirmillo declares when
rousing the dispensarys opponents to battle, Physicians, if theyre
wise, shoud never think / Of any other Arms than Pen and Ink.58
By aligning the writing of profitable prescriptions with the writing of
hack literature, the Dispensary incorporated the satire-as-medicine trope
into a broader attack on the commercialization of learning.
Popes Epistle to Arbuthnot similarly invokes the satire-as-medicine
commonplace to denounce the desire for personal gain, but its critique
focuses more narrowly on the distinction between literature written for
altruistic purposes and literature written with the intention of securing
wealth or fame.59 While the evolution of a competitive marketplace
might legitimately be seen as a threat to all literature, commercialization
and party politics seemed particularly to compromise the therapeutic
purposes of satire and its sister genre, panegyric, as hack writers were
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Joseph. Keen to establish his own importance, the surgeon not only
exaggerates the severity of his patients injury; he also delivers his
diagnosis in a convoluted mixture of ostentatious Latin phrases and
impenetrable medical jargon: The Contusion on his Head has perforated the Internal membrane of the Occiput, and divellicated that radical
small minute invisible Nerve, which coheres to the Pericranium; and
this was attended with a Fever at first symptomatick, then pneumatick,
and he is at length grown deliruus, or delirious, as the Vulgar express
it.65 Like Mrs. Slipslops vocabulary of malapropisms, the surgeons
convoluted languagethe means by which he seeks to demonstrate
his intellectual superiority to his audienceironically becomes the very
means by which his real inferiority of mind is exposed.
Similarly, the medical practitioners who appear in Fieldings
Tom Jones (1749) seem designed to prompt readers into questioning
the prevailing conception of medical knowledge as a marker of elite
intellectual status. When two doctorsthe generically named Dr. Y.
and Dr. Z.are feed at one and the same instant to attend on
Captain Blifil, their dispute over the cause of the captains death suggests that the practice of medical diagnosis is as dependent on the
individual physicians whims as on his store of medical knowledge:
To say the truth, every physician, almost, hath his favourite disease,
to which he ascribes all the victories obtained over human nature.
The gout, the rheumatism, the stone, the gravel, and the consumption
have all their several patrons in the faculty; and none more than
the nervous fever, or the fever on the spirits. And here we may
account for those disagreements in opinion, concerning the cause of
a patients death, which sometimes occur between the most learned
of the college, and which have greatly surprised that part of the
world who have been ignorant of the fact we have above asserted.66
Like the surgeons unwittingly ironic reference to the Vulgar in Joseph Andrews, the narrators distinction between learned physicians
and ignorant laypeople ultimately serves to undermine, rather than
validate, medical practitioners claims to intellectual superiority.
More broadly, we might usefully consider the satire-as-medicine
commonplace as a forum for examining the major philosophical issues
of the period, including the mind-body problem and the relationship
between material and spiritual realms. After all, the practice of medicine
was becoming increasingly material not only in its commercialization,
but also in its gradual acceptance of empirical philosophy.67 Although
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observing that this trope can be located on the fault lines of a number of important cultural divides: between the arts and the sciences,
between the ancients and the moderns, between the learned and
the vulgar, and between the spiritual and the material. For satirists
who understood the practices of medicine and literature as aligned,
medicine and medical practitioners could be used as symbols of, or
stand-ins for, the literary world. For satirists who saw, or wished to
create, a division between literature and medicine, medical practices
and practitioners could be held up as objects of ridicule. Regardless of
whether they were cast as complementary therapies or prescribed as
alternative models of treatment, the harsh Remedies of both satire
and medicine played a key role in shaping the English satiric tradition,
throughout the long eighteenth century and beyond.
NOTES
I would like to thank Ian Burney for his helpful comments on an earlier
draft of this essay.
1. For Drydens remarks in full, see Dryden, Works, 2:5.
2. Randolph, The Medical Concept, 12557. John F. Sena has examined
the concept of the satirist-as-physician in relation to Smolletts Humphry Clinker in
Smolletts Matthew Bramble, 38096.
3. Randolph, 126.
4. By emphasizing the medical metaphor here, I do not mean to suggest that
it was the only such critical commonplace used in satiric theory. Another prominent trope characterized satire as a looking-glass. See, for example, Jonathan Swift,
A Tale of a Tub, 140; Fielding, Joseph Andrews, 189; Kelly, Thespis, 4; The Mirror, 3;
Theophilus Swift, The Temple of Folly, xii.
5. For summaries of this view, see Porter, Disease, Medicine, and Society, 2426;
Lindemann, Medicine and Society, 910.
6. On the link between illnesses and individual identity, see Porter and Porter,
In Sickness and in Health.
7. See Wear, Knowledge and Practice, 154209.
8. On the broad range of medical theories and treatments, see King, The
Medical World, 158; Wear, Knowledge and Practice, 7882; Porter and Porter, Patients
Progress. On the relationship between mind, morals, and body, see Porter and Porter,
In Sickness and in Health, 6075; Wear, Knowledge and Practice, 17884 and 28188.
9. See Porter and Porter, In Sickness and in Health, 2142; Wear, Knowledge
and Practice, 17884.
10. Blackmore, Prince Arthur, 2v.
11. Tate, Characters of Vertue and Vice, A2r.
12. Dryden, Works, 4:55.
13. DUrfey, Scandalum magnatum, 8; see also the prologue to Dryden, Albion
and Albanius: Satire was once your physic, wit your food: / One nourishd not,
and tother drew no blood. / We now prescribe, like doctors in despair, / The
diet your weak appetites can bear (c2r).
14. Emes, Letter to a Gentleman, 5. For other descriptions of satire as a cure
or remedy, see, for example, Newcomb, The Manners of the Age, 58687; Harwood,
To the Worthy Author, A6r-v.
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15. See, for example, Whyte, A Burlesque Upon Musick, in Poems, 215;
Brownsword, Laugh and Lye Down; A Wipe for Iter-Boreale Wilde; A Pill to Purge
State-Melancholy.
16. On the distinction between physicians and surgeons, see Wear, Knowledge
and Practice, 21074; Christopher Lawrence, Democratic, Divine and Heroic, 147.
17. Dryden, 4:7172; this edition translates Ense rescindendum as it must be
cut off with the sword (4.573).
18. On the range of medical practitioners in this period, see Porter, Disease,
Medicine and Society, 1820; Porter and Porter, Patients Progress, 20809.
19. Dryden, Works, 4.75. See also Dacier: those, who do not endeavour
to correct themselvs [sic] by so beautiful a Model, are just like sick Men, who
having a Book full of Receipts, proper to their Distempers, content themselves to
read em,/ without comprehending them, or so much as knowing the Advantage
of them (E6r-v).
20. Scroope, In Defence of Satire, 1:115.
21. See Jewson, Medical Knowledge and the Patronage System, 36985.
22. See Sloan, English Medicine, 59.
23. On the importance of purging corrupted or putrified matter, see Wear,
Knowledge and Practice, 136-43; McMaster, The Body Inside the Skin, 281.
24. Newbery, Poetry Made Familiar and Easy, 131. Amending these words
somewhat, an early American encyclopedia described satire as curing by bitter
and unsavoury, or by pleasant and salutary, applications (Encyclopaedia, 15:249).
25. Johnson, Dictionary. See also Allen, Complete English Dictionary.
26. For examples of such language, see Denis, Select Fables, 326; Dryden,
Works, 2:59, 4:62, 4:63, 4:65, 4:68, 4:79; A Letter to a Friend in the Country, 1011;
Fortescue, Dissertations, Essays, and Discourses, 209.
27. Dryden, 4.71. Drydens reference to Jack Ketchthe executioner famous
for taking eight fumbling strokes to complete the decapitation of the Duke of
Monmouthadds an extra layer of complexity to his metaphor here, as it suggests
that the satirists focus should not be on executing with precision, but rather on
executing in such a way as to cause the greatest pain to the victim.
28. Falconer, Ode, 6.
29. Spirit and Unanimity, 28.
30. Merit, 3. See also A Letter to a Friend in the Country, 1011; The Modern
Englishman, 6; The Neuter, B1r; Newcomb, A Supplement, 10.
31. For descriptions of satirists performing such tasks, see, for example, To
Mr. Pope, By a Lady, xiv; Harwood, To the worthy Authour, A6r-v.
32. On Popes poisoning of Curll, see Popes own satiric pamphlet, A Full
and True Account of a Horrid and Barbarous Revenge by Poison On the Body of
Mr. Edmund Curll, in Prose Works 1:25766; for subsequent discussions of this
episode in literary history, see Baines and Rogers, Edmund Curll, 8085; Mack, Alexander Pope, 295301. I am grateful to Tom Keymer for the suggestion that Youngs
remark may refer to this incident.
33. Young, Conjectures on Original Composition, 9798. Youngs statement
was frequently quoted in subsequent texts, suggesting that it struck a chord with
many readers. See, for example, Anecdotes of Polite Literature, 2:7475 and Biographia
Britannica, 1:55.
34. See, for example, Neville, Remarks, 565.
35. The use of the term scourge in this context was so commonplace as
to render citations hardly necessary. Among the texts cited elsewhere in this essay,
see, for example, A Letter to a Friend in the Country, 10-11; The Modern Englishman,
6; The Neuter, B1r; Newcomb, A Supplement, 10; Falconer, Ode, 6; To Mr. Pope,
xiv; entries for to lash in Johnsons and Allens dictionaries; Denis, Select Fables,
326; Fortescue, Dissertations, Essays, and Discourses, 209.
36. See, for example, Dryden, 4.3536; 4.63; Harwood, To the Worthy Author, A6r; Cooper, Observations on the Present Taste for Poetry, 5, 38; Introduction
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60. Several critics have remarked on the use of medical language or rhetoric
in the epistle. See, for example, Knoepflmacher, The Poet as Physician, 44049;
Douglass, More on the Rhetoric and Imagery of Popes Arbuthnot, 488502.
61. Pope, Imitations of Horace, 13134.
62. Ibid., 6.
63. On the changing status of learned medical professionals, see Wear, Knowledge and Practice, 2129; Holmes, Augustan England, 206-35; Cook, Decline of the Old
Medical Regime. Cooks account complicates Holmess narrative of advancement,
arguing that while learned medical practitioners gained in social prestige, the college of physicians as a body lost much of its power.
64. Trainor speculates on Fieldings opinion of doctors in Doctors in Fieldings Fiction, 11116.
65. Fielding, Joseph Andrews, 63. A similar scene appears in Tom Jones, with
a jargon-happy surgeon called to attend to the wounded Tom: see Fielding, Tom
Jones, 1:38081.
66. Fielding, Tom Jones, 1:112.
67. See Wear, Knowledge and Practice, 47273.
68. Lindemann, Medicine and Society, 7576.
69. On the developments in medicine during the late seventeenth and eighteenth centuries, see King, Road to Medical Enlightenment; Sloan, English Medicine in
the Seventeenth Century, 7090, 17077; Lindemann, Medicine and Society, 101; Lawrence, Charitable Knowledge; Foucault, The Birth of the Clinic. Andew Wear usefully
notes that the commercial need to attract patients effectually transcended many
of the shifts or tensions between competing medical theories. See Wear, Medical
Practice, 294320.
70. King, Road to Medical Enlightenment, 68. On the mechanical model more
generally, see King, The Philosophy of Medicine, 95124; Wear, Knowledge and Practice,
47273. It is worth observing that historians of medicine continue to dispute the
degree to which mechanical theories actually affected medical practice.
71. Rodgers, by contrast, convincingly argues that we might align Sternes
approach to the novel with contemporary physiologists approach to human life.
See Life in the Novel, 120.
72. Many critics have explored the theme of medicine in Tristram Shandy.
See, for example, Porter, The whole secret of health, 6184; Rodgers, Sensibility,
Sympathy, Benevolence, 11758; Hawley, The Anatomy of Tristram Shandy, 84100.
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