Symptomatic Subjects: Bodies, Medicine, and Causation in the Literature of Late Medieval England

Even the most casual readers of medieval literature would find it hard to miss that the corpus of fourteenth- and fifteenth-century English writing is interwoven with a dazzling wealth of medical and surgical language. From the Summoner's “whelkes white” and Arcite's agonizing death in The Canterbury Tales, to the cankered and suppurating Dead Sea in Cleanness, to Margery Kempe's symptomized imitatio Christi, to the “þouȝtful maladie” of Hoccleve's “My Compleinte,” one need not look far to see how critical, even how central, medical writing and thought were to literary writing in medieval England. It would be tempting to reduce the impulse behind such medical language to responses to singular medical events (the medieval plague pandemic obviously springs to mind) or to the increasing codification of medical theory in continental Europe. Julie Orlemanski resists this reductive urge in her marvelous Symptomatic Subjects: Bodies, Medicine, and Causation in the Literature of Late Medieval England. She pursues instead the mutual interpenetration of medical and literary thought across a wide range of complex and frequently conflicting paradigms, embracing the frustrating heterogeneity of medical thought in the Middle Ages to reveal how medicine, like literature itself, navigated the complex synapses among word, world, body, and self. Medical thought and literary thought, Orlemanski shows, are (sometimes literally) the verso and recto of a single leaf, each contributing to and constitutive of the embodied subject within the medieval world.Orlemanski sets herself no small task in Symptomatic Subjects, but if her subject at times seems daunting in its breadth—“This study investigates what late medieval writers were up to in using ‘termes of phisik’ in their compositions” (p. 1), she writes, with a breezy offhandedness that belies the gravity of her central proposition—she handles it artfully, building a structure that moves gradually from a straightforward consideration of medicine within late medieval England to a nuanced investigation of the multidirectional “voice” that medieval literary works developed to both invoke and speak back to discourses of physic, morality, causation, and signification. Beginning in the first section, “Thinking with Phisik,” Orlemanski details much of the textual evidence of medieval medical thought and practice, revealing in the process the complex tensions and contradictions that defined the field of medicine in late medieval England. Unlike Paris, Bologna, and other Continental cities that boasted influential faculties of medicine and established medical guilds, England was marked by its relative lack of organized medical infrastructure. Orlemanski evokes a practice of physic in England that inhered to “a heterogeneous network of physicians, apothecaries, astrologers, members of barber-surgeon guilds, itinerant ‘leeches’ with and without formal education, midwives, tooth-drawers, oculists, parish priests, monastic communities, saints’ shrines, and members of their own or local households” (p. 22), and she shows how theories of causation, conceptions of the relationship between symptom and illness, understandings of contagion, and questions of medical authority developed within and through it. At the same moment, Orlemanski weaves the literary deftly into the medical, bringing Chaucer's famously symptomatic Summoner, the General Prologue's portrait of the Doctor of Physik, and works like Dives and Pauper into conversation with medical tracts, sermons and theological works, and theoretical writing. The exchanges that Orlemanski stages through these textual collisions are always individually provocative. In the aggregate, moreover, they work to reveal medieval physic as a kind of ongoing hermeneutic, one notably akin to textual literary analysis. Physik becomes, in this reading, an inconsistent but powerful model of interpretation that literary writers exploited as they grappled with similar questions in their own work.In part two, “Playing with Physik,” Orlemanski moves from the fragmented medical landscape that she develops in part one to consider how medicine is implicated in two specific literary modes, satire (chapter three) and exemplum (chapter four). In her analysis of the former she focuses on three works—Chaucer's Nun's Priest's Tale, Henryson's lesser known satire “Sum Practysis of Medecyne,” and the East Anglian Croxton Play of the Sacrament—and argues that medical satire, an often jargony subgenre that called into question the efficacy of physik to achieve its own stated aims, emerged at a moment “when medical discourse functioned as a novel textual laboratory for configuring words, bodies, and substances into new relations” (p. 82). By contrast, Orlemanski's consideration of the latter genre, which culminates in a reading of two tales popularized in the Middle Ages through the Gesta Romanrum, reveals how medical discourse and didactic forms like the exemplum, the miracle story, and the sermon cross-pollinated one another, generating a nuanced etiological field within which the relationships among body and soul, cause and symptom, infection and cure were constantly, if idiosyncratically, renegotiated. Convincing as they are, the chapters comprising part two are perhaps the most expected in the monograph, offering more or less straightforward readings of how the medical discourse of the Middle Ages appears in and contributes to contemporaneous literary works. It is a testament to Orlemanski's generosity and insight as a scholar, however, that she chooses not to end Symptomatic Subjects with these straightforward readings but to push further, exploring how medical language underwrites both narrative itself and the poetic voice marshaled by medieval literary texts.To do this, Orlemanski turns in the second half of the book to a series of in-depth case studies, each developing and expanding the connections introduced in the earlier chapters. The description of Arcite's death in The Knight's Tale, which is marked by Chaucer's sudden deployment of a sophisticated and highly technical medical vocabulary, becomes for Orlemanski an invitation to rethink the cosmic unities promised by Theseus but perpetually queried by the tale itself and finally brought to crisis in the figure of Arcite's broken body. Henryson's Testament of Cresseid, in which leprosy emerges as the unambiguous signifier of Cresseid's surprisingly ambiguous transgressions, likewise hinges on the fluid causal relationships among body, morality, symptom, and disease, while Hoccleve's “wylde infirmite” in The Series becomes a space within which both authorial presence and poetic voice are uneasily negotiated. Finally, Margery Kempe's Booke (which, like Hoccleve's Series, thoroughly symptomizes the affective reactions of its autobiographically inflected subject) considers how “the microdrama of embodiment, agency, and causation” (p. 252) staged by Margery's weeping and roaring spirals outward to articulate both an authorial voice and an increasingly confident spiritual praxis. This quartet of readings, all of which engage in provocative conversation with other major critical debates in the field, reveals the high degree to which physik affected late medieval literary writing. Equally important, the readings powerfully demonstrate how literature itself participated in the same questions of causality, embodiment, and authority raised by medieval medical discourse.Meticulously researched, compellingly argued, and lucidly written, Symptomatic Subjects is a bravura performance. On the most immediate level, the book's individual readings—particularly those in its second half—offer important challenges to established critical orthodoxies about some of the most important texts of the late medieval period. More broadly, however, the book makes a convincing case for reading medieval literature through the prism of contemporary medical discourse, and it shows how the very issues most strenuously interrogated by medieval physik were, in fact, tightly bound up with the questions most urgently pursued by Middle English writers and thinkers.

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