344 BOOK REVIEWS sound book on doctors and medicine in the works of Herman Melville. His writing style reveals lapses in places—in the organization of some of his paragraphs and in some of his constructions. "Cruising toward the Japanese whaling grounds, Ahab's purpose intensifies" (p. 88) is illustrative. One might wish that the Garland editors and the series editor had given Smith a bit more help. But what we have is a study of an important aspect of Melville's career, a book that—though Melville and medical purists might quail—serves, with solidity and clarity, to interest and enlighten. —Gerard M. Sweeney University of Akron John Wiltshire, Samuel Johnson in the Medical World: The Doctor and the Patient. Cambridge: Cambridge University Press, 1991. χ + 293 pp. Clothbound , $39.50 For readers with a fondness for Samuel Johnson (1709-1784), this study of the connection between his life as a patient and medical adviser and his writings on illness, therapeutics, and medical theory is a good survey of the medical world of eighteenth-century England. John Wiltshire takes what is known about Dr. Johnson's life and work and gives it a good quarter-turn to reveal the sufferer, the Samuel Johnson whom Boswell could scarcely see. He was a man who labored throughout his life against often debilitating physical and psychological maladies, and, consequently, a moral thinker who had strong opinions about how medical knowledge ought to be acquired and applied. For Johnson "doctors became friends, and his friends, like Mrs Thrale, became doctors" (p. 223). At one time or another, he knew both William Hunter, the eminent surgeon, and Joshua Ward, the equally renowned maker of patent medicines, and had as his physician, among others, Thomas Lawrence, Richard Brocklesby, and William Heberden. He wrote essays on medical subjects, reviewed medical treatises, meditated on disease and suffering in his essays and biographies, and freely and emphatically dispensed medical and psychological advice along with moral guidance in letters to his friends. Wiltshire uses all these sources to give us a view of Johnson as a man who, as a part of his moral and Book Reviews 345 practical concerns, lived and breathed eighteenth-century English medical theory and practice. Wiltshire begins with a strong first chapter on Johnson's anguished life as a patient—from the political and medical climate that led his mother to take her scrofulous toddler to be healed by Queen Anne's touch in 1712 to the nearly modern patho-anatomical conclusions of his autopsy in 1784. He documents eye troubles, hearing difficulties, a gait disturbance, the possibility of Tourette's syndrome, compulsive behavior, gout, asthma, melancholy, a persistent depression that required some sort of confinement at the Thrales' house in 1767 or 1768, and his final two years of "dropsy"—with edema, pulmonary dysfunction, and episodes of aphasia. On autopsy, Johnson was found to have aortic stenosis, emphysema, and a large gallstone. But the book is not the literary pathography this chapter might seem to promise. Wiltshire is concerned to estabüsh Johnson as a medical thinker and an amateur medical practitioner, and at times we lose our sense of him as a sufferer, even as a thinker, in the minutiae of his medical reviews and journalistic pieces. In the historical and biographical essays, many of them Johnson's anonymous early hack work, Wiltshire discerns a rational, skeptical approach to both theory and practice that is borne out in his life and opinions. Johnson wrote biographies of physicians, including Sydenham and Boerhaave, and the preface to Robert James's Medicinal Dictionary (1743^5), and he contributed skeptical reviews of philosophical and medical works to the Literary Magazine. The argument here is careful: This is a body of writing, very probably Johnson 's, out of which Wiltshire wants to construct the man's attitudes toward medicine. But at the same time, as part of his evidence of authorship , he must use Johnson's characteristic skepticism, a trust in observing before theorizing that goes back to Locke and Hippocrates, and his vivid attention to human suffering. He relies on fine textual evidence. Not a lively read—until we get to Johnson's reply to Soame Jenyns...
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