Meegan Kennedy, Revising the Clinic: Vision and Representation in Victorian Medical Narrative and the Novel (Columbus: Ohio State University Press, 2010), pp. x + 261, $39.99, hardback, ISBN: 978-0-8142-1116-8.

Abstract

Revising the Clinic is an ambitious work that sweeps through time from the eighteenth-century medical case history, to Freud at the turn of the twentieth, and integrates analysis of forms of representation in both literary and scientific texts. It is perhaps misleadingly titled, since there is little on clinical case histories between the Philosophical Transactions in the eighteenth century, and Freud at the close. The actual focus lies pre-eminently on forms of vision and representation in the Victorian novel. Whilst there is some discussion of medically related scenes in the novels, the link to science and medicine functions mostly at the level of methodology. Rather than look at specifically medical scenes, Kennedy draws on Lorraine Daston and Peter Galison’s Objectivity (2007) to establish a model of ‘mechanical observation’ that she sees as operative in both scientific and literary texts. The readings of George Eliot’s Adam Bede and Middlemarch thus focus on issues concerning vision and perception, and optical metaphors, rather than representations of illness or bodily ailments. The method is fruitful with regard to yielding new insights into the novels, but not entirely convincing with regard to the parallels drawn with ‘clinical realism’. One of the problems is that Daston and Galison’s arguments, developed with reference to scientific atlases, do not translate easily into clinical medicine. As Kennedy points out in the Middlemarch chapter, the emergence of experimental medicine brought with it a new emphasis on speculation and imagination. ‘Mechanical objectivity’ or ‘observation’ does not capture the complexity of nineteenth-century medical practice, whilst the methodology tends to give primacy to the scientific domain, so that the literary is seen as applying or modifying the scientific, rather than evolving alongside in a process of mutual exchange. More emphasis on the nineteenth-century case history, particularly in the emerging sphere of psychiatry, would have helped to make this case, and also ensured that Freud did not emerge at the end as a sudden and complete departure from previous practice. These quibbles suggest the complexity of Kennedy’s undertaking. Within this perhaps over-ambitious frame there is much of interest. There are good readings of sentimental deathbed scenes in Charles Dickens’s works and in Elizabeth Gaskell’s Ruth, showing how graphic physical detail can be used to build a form of spiritual transcendence. The chapter on clinical realism in the Victorian periodical makes good use of the electronic index of book reviews in the Athenaeum to explore the extraordinary number of nine hundred reviews completed by Edwin Lankester, mostly on scientific and medical topics. It also draws on the work of the Science in the Nineteenth-Century Periodical project for its analysis of science in the Cornhill and Macmillan’s Magazine. In neither case, however, does it actually cite the electronic source; Kennedy no doubt assumes that both sources could be easily found, but I would like to make a plea for the full referencing and bibliographical citation of electronic sources. The book concludes with a chapter linking the work of Freud with that of Rider Haggard, following up Freud’s suggestion in The Interpretation of Dreams that She (1887) was ‘a strange book, but full of hidden meaning... the eternal feminine, the immortality of our emotions’ (quoted p. 190). Although much has been written on Freud’s methodology, particularly from a literary perspective, Kennedy offers an interesting re-working of notions of romance, drawing on Northrop Frye, to outline the imperialist, romantic quest figured in Freud’s language of exploration. As suggested earlier, however, the fact that Revising the Clinic has not looked at nineteenth-century psychiatric narratives means that Freud is rather taken at his own estimation as a figure who overturns preceding practice. Clearly there are many novel elements in his work, but they would emerge more starkly in an analysis that took into account his immediate predecessors. Kennedy concludes that at the beginning of the twentieth century ‘the novel and its insights had become altogether unavailable as a discursive model for medical prose’ (p. 202). This is, I believe, an overstatement of the case, and overturns some of the complexity mapped out in the text, returning us to a rather standard model of the triumph of clinical objectivity at the turn of the century. Revising the Clinic has much to offer the reader. Whilst its more sweeping claims are not always convincing, it is always engaging, and offers new ways of thinking about the relationships between literary and medical narrative.