Medical Paratexts from Medieval to Modern

Dissecting the Page

Hannah C. Tweed, Diane G. Scott, Hannah C. Tweed, Diane G. Scott

• Publisher: Palgrave Macmillan
• Year: 2018
• ISBN:
  9783319734262
• Topic: Literature
• Subtopic: European Literary Criticism
• Index: Literature

This collection establishes the term 'medical paratexts' as a useful addition to medical humanities, book history, and literary studies research. As a relatively new field of study, little critical attention has been paid to medical paratexts. We understand paratext as the apparatus of graphic communication: title pages, prefaces, illustrations, marginalia, and publishing details which act as mediators between text and reader.Discussing the development of medical paratexts across scribal, print and digital media, the collection spans the medieval period to the twenty-first century. Dissecting the Page is structured in two thematic sections, underpinned by a shared examination of ideas of medical and lay readership and a history of reader response. The first section focuses on the production, reception, and use of medical texts. The second section analyses the role and significance of authority, access, and dissemination in discussions of health, medicine, and illness, for both lay and medical readerships.

© The Author(s) 2018

H. C. Tweed, D. G. Scott (eds.)Medical Paratexts from Medieval to ModernPalgrave Studies in Literature, Science and Medicinehttps://doi.org/10.1007/978-3-319-73426-2_1

Begin Abstract

1. Authority, Authenticity and Reputation: An Introduction to Medical Paratexts

Hannah C. Tweed¹ and Diane G. Scott²

(1)

University of York, York, UK

(2)

University of Glasgow, Glasgow, UK

End Abstract

Case Study: Mary Toft

In September 1726, John Howard , a surgeon from Guildford, witnessed Mary Toft deliver nine rabbits. By October, Toft was being visited by members of the public and medical professionals alike as a medical curiosity. Her case was discussed and dissected in newspapers , printed ballads and satirical sketches, and Toft ’s predicament was considered by many to be an example of the maternal imagination—her rabbit births the result of eating and craving rabbit meat while pregnant (Lieske 2007: xiii). In November, following three months of similar sporadic ‘births’ and increasing public interest, Nathanael St. André , surgeon and anatomist to the Prince of Wales, and Cyriacus Ahlers , surgeon to George I’s German household, visited Toft in Guildford, where she was again observed delivering parts of a rabbit (Todd 1995: 26–27). Suspicious of fraud, Ahlers ’ reports led fashionable physician Richard Manningham to examine Toft , delivering an object subsequently identified as a hog bladder. Toft was finally moved to London and observed by the trio of surgeons and physicians, along with new specialist ‘men-midwives’, such as James Douglas , while being pressured to admit fraudulent delivery. Eventually, following evidence that Toft ’s husband and a porter were supplying her with dead rabbits (and Manningham’s threat to perform a forced caesarean section), Toft finally confessed to the fraud.

Douglas ’ published response, An Advertisement Occasion’d by Some Passages in Sir R. Manningham’s Diary , Latedly Publish’d, by J. Douglas , M.D., ¹ presented a copy-edit of Manningham’s publication, querying the accuracy of certain sections and reiterating his own claims to have never been convinced by Toft , as well as detailing her symptoms and habits. Yet while the content of these two texts might indicate an intended audience of medical professionals , Toft ’s melodramatically entitled Much ado about Nothing: Or, The Rabbit-Woman’s C onfession, and popular ballads such as The D iscovery : or, The Squire turn’d Ferret. An Excellent New B allad demonstrate how the commentaries were titled with a view to public consumption as much as (if not more than) medical professionals . Mary Fissell’s work on the politics of reproduction in early modern England draws connections between the availability of monstrous birth narratives in cheap printed pamphlets and a cultural shift in the way the womb was viewed across society, both medical and lay. In a post-Reformation society, women were no longer encouraged to identify with the Virgin Mary during pregnancy , and the womb , previously a site of miraculous life-giving, was increasingly viewed as ‘the source of many women’s maladies’. Cheap print allowed for the proliferation of sensational stories, and women’s bodies, pregnancy and motherhood were popular choices (Fissell 2006: 53).

The Toft affair certainly highlights developments in print technology and the commercial possibilities it afforded eighteenth-century printers and publishers; more importantly, however, it also demonstrates how the eighteenth-century medical marketplace was able to exploit the promotional potential of print. The physicians involved in the case were keen to document their work and observations, and some made their way quickly into print. Both The Wonder of Wonders,² which contains an excerpt of correspondence by surgeon John Howard , and A Short Narrative,³ written by Nathaniel St André , were published shortly before Toft ’s confession (Lieske 2007: 21). In addition to providing details of the surgeons’ actions in the case, both texts attempt to quell doubts over the authenticity of the births and ‘counter an anticipated assault on [the physicians’] public and professional image’ (Lieske 2007: xii).

That so many well-respected medical professionals were fooled or even implicated in the fraud triggered further waves of published material relating to the affair. In the months following Toft ’s confession, the physicians, surgeons and midwives involved in the case published a number of pamphlets and accounts defending their own professional reputations (and often laying blame on other parties). These publications were undeniably sensational in nature, as well as deeply intertextual—requiring and expecting from their readers a substantial knowledge of the case and the associated medical details. Manningham’s published diary extracts, for example, present the case in explicit medical detail, while also cementing his claims to have never been convinced by the births.⁴

Mary Toft ’s case engaged with a range of eighteenth-century concerns by and about the medical profession: the role of sensationalism in professional practice; public questions about medical authority and verisimilitude; the accountability of medical men to the public (of all classes). As Pamela Lieske states, however, the Toft case ‘did not occur in a cultural vacuum, but [is] part of a larger historical tradition of strange and monstrous births, whose meaning contemporary scholars are still attempting to decipher’ (Lieske 2007: viii). Situating the Toft affair within a history of ‘monstrous births’ which stretches back to the medieval and classical periods, Lieske argues that such cases should not be dismissed as mere fantasy, but that we should consider how the medical profession made ‘concerted efforts [. . .] to make sense of what they observed and experienced’ (Lieske 2007: viii). Mary Toft may have been at the centre of the affair, but her female body quickly became a physical and rhetorical battleground between the male medical professionals defending their reputations and livelihoods.

The Mary Toft case has long been noted as a bizarre but intriguing example of late eighteenth-century medical and gynaecological practices⁵ and, from a book history perspective, of the role of the popular press during this time. This chapter, however, aims to draw attention specifically to the paratextual features of the various publications. Paratext constitutes the linguistic and visual features which are contained within and surround the main text(s); meaning and information are communicated by and encoded in these features.⁶ More specifically, the various Toft publications are examples of the ‘medical paratext’ and highlight the breadth and complexity of material which this term may encompass. In addition to demonstrating wider concerns and preoccupations within the eighteenth-century medical profession, the Toft affair texts and their paratexts also reflect contemporary public opinion about physicians and their trade. A focused investigation of the paratext not only highlights the complexities of the case itself, it provides insight into the structures and knowledge base of the medical profession in the late eighteenth century . Furthermore, the various elements of paratextual detail and the distinctive inter(para)textuality expose the tensions between public and professional, medical and lay, and privacy and sensationalism.

Paratext is always a site of mediation between the reader, printer/publisher, editor, and author; it is often also a site of tension.⁷ This tension is clearly evidenced in the Toft publications, as medical professionals used the printed text and its paratextual framing devices to promote their expertise, defend their reputations and demonstrate accountability to the reading public. Furthermore, many of the texts were produced in direct response to each other, and to developments—allegations and revelations—over the course of the affair. As such, the texts, and specifically the paratexts, are dialogic. Titles such as An Advertisement Occasion’d by Some Passages in Sir R. Manningham’s Diary , Latedly Publish’d, by J. Douglas , M.D., a tract in which Douglas makes ‘remarks’ upon Manningham’s account, are explicit in their inter(para)textuality. Acknowledging the paratext, then, not only demonstrates how medical professionals responded to the case, but how they engaged with each other, and to the wider reading public.

The voices of the male physicians take centre stage across the publications but the voice of Mary Toft is notable in its absence; when we do ‘hear’ her voice, it is heavily mediated. The following text comprises the opening pages of Toft ’s printed confession, Much ado About Nothing, which features an explanatory preface from the publisher:

The Publisher to the Reader

The poor woman of Godalming being now the topic of every conversation, and it being put to the general vote, whether rabbits shall be admitted to our tables, ay or no; it has been thought fit to trace the whole affair from its first original; and to hear what the poor woman has to say for herself, at a time when all mouths are open against her: in order to which, the publisher hereof has taken indefatigable pains to bring the whole mystery to light, by purging the woman in a proper manner, and at proper times, without the low artifice of wheedling, or the high hand of threatening; but by touching her in the tenderest part, vis. her conscience ; and extracting the very quintessence of the whole affect in such a manner, and method, as will set all mankind to rights in their various mistaken notions of this unhappy woman.

It is therefore to be hoped, they will suspend their judgements, till they have heard what she has to say for...

Table of contents

• Cover
• Front Matter
• 1. Authority, Authenticity and Reputation: An Introduction to Medical Paratexts
• Part I. Production, Reception, and Use
• Part II. AuthorityAuthority , Access, and Dissemination
• Correction to: “Nonsense Rides Piggyback on Sensible Things”: The Past, Present, and Future of Graphology
• Back Matter