The Medical Imagination: Literature and Health in the Early United States

The Medical Imagination: Literature and Health in the Early United States

The Medical Imagination: Literature and Health in the Early United States

The Medical Imagination: Literature and Health in the Early United States


In 1872, Ralph Waldo Emerson wrote, "Science does not know its debt to imagination," words that still ring true in the worlds of health and health care today. The checklists and clinical algorithms of modern medicine leave little space for imagination, and yet we depend on creativity and ingenuity for the advancement of medicine--to diagnose unusual conditions, to innovate treatment, and to make groundbreaking discoveries. We know a great deal about the empirical aspects of medicine, but we know far less about what the medical imagination is, what it does, how it works, or how we might train it.

In The Medical Imagination, Sari Altschuler argues that this was not always so. During the eighteenth and nineteenth centuries, doctors understood the imagination to be directly connected to health, intimately involved in healing, and central to medical discovery. In fact, for physicians and other health writers in the early United States, literature provided important forms for crafting, testing, and implementing theories of health. Reading and writing poetry trained judgment, cultivated inventiveness, sharpened observation, and supplied evidence for medical research, while novels and short stories offered new perspectives and sites for experimenting with original medical theories.

Such imaginative experimentation became most visible at moments of crisis or novelty in American medicine, such as the 1790s yellow fever epidemics, the global cholera pandemics, and the discovery of anesthesia, when conventional wisdom and standard practice failed to produce satisfying answers to pressing questions. Throughout the eighteenth and nineteenth centuries, health research and practice relied on a broader complex of knowing, in which imagination often worked with and alongside observation, experience, and empirical research. In reframing the historical relationship between literature and health, The Medical Imagination provides a usable past for contemporary conversations about the role of the imagination--and the humanities more broadly--in health research and practice today.


EXPER’IMENT, Experimen’tum; same etymon. (F.) Expérience.
A trial, made on the bodies of men or animals, for the purpose of
detecting the effect of a remedy, or of becoming better acquainted
with their structure, functions, or peculiarities. in a more general
sense, it means any trial instituted with the intent of becoming
better acquainted with any thing.

—Robley Dunglison (“The Father of American Physiology”),
Medical Lexicon (1839)

In the fall of 1841, physician and novelist Dr. Robert Montgomery Bird (1806– 1854) stood before a group of new medical students and delivered what must have been a dispiriting talk. in The Difficulties of Medical Science, Bird explained that medicine faced many challenges. Every science, he told his students, was, “and of a necessity must be, imperfect,” but the difficulties of medicine were “greater and more numerous.” It was hard to reproduce results, for example. It was impossible to observe healthy, functioning organs. the senses were imperfect, and human bodies were incommensurably unique. “It is physically impossible,” Bird stressed, to “know many things it would delight Medicine to know.” Bird was committed to medicine, whose “whole object” was to benefit humanity and to reduce suffering, but he worried about the immense physical and ethical impediments to medical research. “How shall we detect the workings of the invisible and intangible enemies around us?” he asked. “How shall we trace the mechanism of a disease? how shall we follow even the operation of a remedy, through the darkness of a microcosm of which we are so ignorant?” “We have no window of Momus,” Bird lamented, “to give us vistas of living pathology.”

Invoking Momus, the classical figure who teased Hephaestus for making the body without a window through which to see the human heart, Bird . . .

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