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A Geography of Medical Knowledge: Country Doctors in Elizabeth Stuart Phelps and Sarah Orne Jewett

Published online by Cambridge University Press:  19 July 2010

MARK STOREY
MARK STOREY
Affiliation:
School of American and Canadian Studies, University of Nottingham. E-mail: [email protected]
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Abstract

This essay examines two of the best-known postbellum representations of country doctors, Elizabeth Stuart Phelps's Doctor Zay (1882) and Sarah Orne Jewett's A Country Doctor (1884). While they have often been considered from a feminist point of view, this essay seeks both to complement and to argue against these existing readings by bringing a specifically geo-medical framework to bear on the texts. I consider both the thematic and the generic implications of representing country doctors in the postbellum era, exploring how they reflect, refract and encode the state of medical knowledge in postbellum America. I argue that literary representations of country doctors can contribute to an understanding of postbellum medical modernization by decentring it – by, in a sense, allowing us to comprehend the course of modern medical knowledge from a place usually assumed to remain outside modernity's transformations. Whilst I do, therefore, approach both these novels from a loosely new historicist perspective, I also want to think about how the social context they were engaging with determined, constrained and embedded itself into the thematic, formal and generic makeup of the novels themselves. Ultimately, this essay not only offers fresh readings of two important late nineteenth-century novels, but makes an intervention within the wider debates about nineteenth-century medical history and geography.

Type
Research Article
Information
Journal of American Studies , Volume 44 , Issue 4 , November 2010 , pp. 691 - 708
Copyright
Copyright © Cambridge University Press 2010

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References

1 Claude Bernard, An Introduction to the Study of Experimental Medicine (1865), trans. Henry Copley Greene (New York: Dover Publications, 1957), 1.

2 Ibid., 2.

3 William Osler, “Medicine in the Nineteenth Century” (1901), in Aequanimatis (London: H. K. Lewis, 1948), 223–24.

4 While these two men do indeed represent the dominant trend in the medical profession of their time, the notion that antebellum medicine was devoid of scientific thinking is inaccurate. See especially Warner, John Harley, “The History of Science and the Sciences of Medicine,” Osiris, 2, 10 (1995), 164–93CrossRefGoogle Scholar.

5 Ann Anderson, Snake Oil, Hustlers and Hambones: The American Medicine Show (Jefferson, NC and London: McFarland and Company, 2000), 30.

6 The practice takes its name from its founder, Samuel Thomson, who first advocated his form of medicine in his 1822 bestseller, New Guide to Health. Believing in vitalism and the healing power of nature, Thomsonian treatments consisted mainly of “steam baths and botanical remedies.” John Duffy, The Healers: A History of American Medicine (Urbana: University of Illinois Press, 1979).

7 William G. Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore: The Johns Hopkins University Press, 1972), 129.

8 Duffy, 112.

9 Deborah Lupton, “Foucault and the Medicalisation Critique,” in Alan Petersen and Robin Bunton, eds., Foucault, Health and Medicine (London and New York: Routledge, 1997), 95.

10 Ibid., 100.

11 Ibid. 104.

12 Michel Foucault, The Archaeology of Knowledge (1969), trans. A. M. Sheridan Smith (London: Routledge Classics, 2002), 59.

13 Ibid., 56.

14 Quoted in Rothstein, 205.

15 Dierig, Sven, Lachmund, Jens and Mendelsohn, J. Andrew, “Toward an Urban History of Science,” Osiris, 18 (2003), 15CrossRefGoogle Scholar.

16 Ibid., 15.

17 The term is Henri Lefebvre's, who in The Urban Revolution (1970), trans. Robert Bononno (Minneapolis: University of Minnesota Press, 2003), talks of the need to lose sight of “the city” as a clearly defined object and instead view “the urban” as a system of social relations that finds its organizing focus in the city: “These relations are both legible and illegible, visible and invisible. They are projected onto the landscape in various places … Once they are grasped at this level, the urban reality assumes a different appearance” (46–47). I am suggesting these considerations are applicable to the late nineteenth-century context, and that medical knowledge is one example of the “invisible relations” that transform the city–country binary into a more intricately woven “urban fabric.”

18 Elizabeth Stuart Phelps, Doctor Zay (1882) (New York: The Feminist Press, 1987), 11. All further references are included in the body of the text.

19 Rothstein, 246. Homeopaths – believing in the treatment of disease by application of hugely diluted medicines that would induce the same symptoms as the disease itself – had a long-running and often acrimonious struggle with regular doctors (or ‘allopaths’) who sought to treat disease by administering treatments that would have an opposed effect. It was this iconoclastic approach to orthodox medicine's fundamental assumptions that meant homeopaths were excluded when the American Medical Association was formed in 1847, a decision that would effectively discredit homeopathy and condemn it to professional marginalization by the end of the century.

20 Ibid., 235.

21 Bangor would have had a far more “urban” character in 1882 than its image today suggests; the lumber industry in the region made it one of the East Coast's busiest ports.

22 A key context here, of course, is the changing place of women within the medical profession: in 1860 there were just 200 practising female physicians in the United States, a number that had risen to over 7,000 by the turn of the century (Baym, 176). As prominent representations of professional women, both Phelps's and Jewett's novels have been widely discussed in relation to feminist history and literary scholarship; see especially Nina Baym, American Women of Letters and the Nineteenth-Century Sciences: Styles of Affiliation (New Brunswick: Rutgers University Press, 2002); Cynthia J. Davis, Bodily and Narrative Forms: The Influence of Medicine on American Literature, 1845–1918 (Stanford, CA: Stanford University Press, 2000), and Stephanie P. Browner, Profound Science and Elegant Literature: Imagining Doctors in Nineteenth-Century America (Philadelphia: University of Pennsylvania Press, 2005). For a broader historical account of women physicians in late nineteenth-century America see Regina Morantz-Sanchez, Sympathy and Science: Women Physicians in American Medicine (Chapel Hill: University North Carolina Press, 2000).

23 Baym, 185.

24 Browner, 165.

25 Raymond Williams, The Country and the City (St. Albans: Paladin, 1973), 100.

26 Pryse, Marjorie, “‘I Was Country When Country Wasn't Cool’: Regionalizing the Modern in Jewett's A Country Doctor,” American Literary Realism, 34, 3 (Spring 2002), 217–32, 220–21Google Scholar.

27 Ibid., 228.

28 Browner, 170.

29 Frederick Wegener, “Introduction,” in Sarah Orne Jewett, A Country Doctor (1884), ed. Frederick Wegener (New York: Penguin Books, 2005), xvii.

30 Jewett, 44. All further references are included in the body of the text.

31 Dr. Benjamin Rush (1746–1813), hugely influential physician and co-signer of the Declaration of Independence, advocated the aggressive and drastic treatments that typified the “heroic” medicine of the eighteenth and early nineteenth centuries.

32 Dierig, Lachmund and Mendelsohn, “Toward an Urban History of Science”, 15.

33 There is a poignant biographical note worth mentioning here. The model for Dr. Leslie seems to have been Sarah's own father, Theodore Jewett, a respected physician and surgeon who served the town of Berwick in Maine and, later, the state medical school. Sarah herself would write his obituary in 1879 (it was published anonymously), and there is a touching sense throughout that her father's career never achieved the recognition it deserved because his own delicate health required that he live a provincial life: “It could not help being, at times, somewhat a lonely life, for he was shut out from the larger circle of professional friends, with its pleasures and advantages, to which he would have belonged in a city” (Jewett, 267). Such personal sentiments undoubtedly came to be part of Jewett's narrative concerns in A Country Doctor.

34 Wegener, 255 n.

35 Lawrence Rothfield, Vital Signs: Medical Realism in Nineteenth-Century Fiction (Princeton: Princeton University Press, 1992), 148.

36 Ibid., 148.

37 Davis, Bodily and Narrative Forms, 14.

38 Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), 81.

39 Michael Sartisky, “Afterword” to Phelps, Doctor Zay, 261.

40 Baym, American Women of Letters and the Nineteenth-Century Sciences, 189.