Susan Wells uses the methods of literary criticism to ... Wells notes the temptation to argue that women .... butions of both Alfred C. Kinsey and William H. Masters ...
Methods/Theory SUSAN WELLS. Out of the Dead House: NineteenthCentury Women Physicians and the Writing of Medicine. Madison: University of Wisconsin Press. 2001. Pp. xii, 312. Cloth $57.95, paper $22.95. Susan Wells uses the methods of literary criticism to decode historical documents, providing a rich analysis of writings by women physicians throughout the nineteenth century. That was the "golden age" of women in medicine, before the reforms advocated by the Flexner Report restricted the field almost exclusively to men. Wells notes the temptation to argue that women developed an alternative form of medical practice. Wisely, she makes a more limited claim: that female physicians made many of the same therapeutic choices as men but that their experiences and the responses they met were very different. Drawing on Judith Butler's notion of gender as performance, Wells demonstrates how women physicians constructed their identities within the various rhetorical strategies available to them. The first substantive chapter examines the extent to which men and women conducted medical interviews differently. Women physicians took special pride in their ability to listen empathetically to their female patients and elicit their "heart histories." The intimacy that developed enabled female physicians to intervene actively in the lives of their patients, offering them advice on morality, financial matters, and religion as well as on the care of their bodies. The following chapter analyzes the extensive writings of Ann Preston, who graduated from the Women's Medical College of Pennsylvania in 1850 and remained there first as professor of physiology and then as dean. By describing herself as acting in ways that were indistinguishable from those of male physicians, Preston advanced the interests of the college but hurt herself both personally and professionally. In the next chapter, Wells first compares midcentury student theses at the Women's Medical College with those at the School of Medicine of the University of Pennsylvania, an institution attended only by men. Although the two groups of theses were similar in most respects, women students were far more likely to criticize the medical profession and to employ satire. The chapter concludes with a fascinating analysis of a group of theses by African-American women students at the Women's Medical College in 1870, demonstrating how they negotiated issues of race as well as gender. In the two succeeding chapters, Wells analyzes the contrasting rhetorical styles of Hannah Longshore, who aligned herself with "irregular" medical practice, including homeopathy, the water cure, mesmerism, and spiritual healing, and Mary Putnam Jacobi, a prominent physician who fully endorsed the new scientific medicine emerging in the late nineteenth century. While Longshore used travesty to convey her ambivalence toward the medical profession, Jacobi frequently adopted the cool, dispassionate tone of the
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male medical writer. The final chapter explains how women physicians succeeded in gaining entry to both public dissections and clinical lectures, thus upsetting notions of female delicacy and raising the fearsome possibility that men as well as women could be the object of the medical gaze. Although Wells offers subtle analyses of a wide variety of writings, she occasionally could have delved even more deeply into some of the texts she examines. She argues, for example, that Preston based her 1863 lecture, "Nursing the Sick and the Training of Nurses," on her recent, long bout of illness. It is unclear, however, exactly how Preston's personal experience of suffering informed her argument that patients resembled children. Wells carefully avoids most literary jargon, although some historians may find her writing too dense. But they should persevere. By challenging historians to embrace new ways to examine texts from the past, this book makes a valuable contribution not only to the literature on women in medicine but also to historical studies generally. EMILY K. ABEL University of California, Los Angeles CAROL GRONEMAN. Nymphomania: A History. New York: W. W. Norton. 2000. Pp. xxiii, 238. $24.95. Carol Groneman's history of nymphomania addresses a topic that has long needed a full-scale analysis by a feminist historian and raises nearly all of the important questions about this ill-defined and now obsolete disease paradigm. Her book elucidates two main points. The first is that "As new sexual rules develop in the twenty-first century, anxieties persist: How much is too much? How much is not enough? Is there a healthy, normal, natural amount of sex? And who decides?" (p. xvii). The second point is that women, far more often than men, are determined by their partners and/or physicians to be outside the "normal" boundaries, either as "frigid" or as sexually insatiable, or, paradoxically, both at once. In the case of women whose desires were thought to be excessive, "nymphomania was in the eye of the beholder" (p. 70). Groneman depicts the search by physicians and psychologists since the nineteenth century for a sexual norm for women as a kind of unrewarding Goldilocks quest: this one is too hot, this one is too cold, but where is the woman who is "just right"? She also points out how rarely the male counterpart, satyriasis, was diagnosed compared to the legions of women labeled nymphomaniacs since the 1850s. Some of her critique of the medicalization of women's sexuality sounds familiar, but this is hardly Groneman's fault. Like the symptoms of "hysteria," assertive sexual behavior by women that caused trouble for their male partners was diagnosed as a disease and treated by physicians, usually without raising any questions about the legitimacy of enforcing a norm that was not
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Reviews of Books
and probably could not be determined. The mere existence of such a disease paradigm was reassuring to those deeply invested in the androcentric model of sexuality: it validated the male adolescent fantasy of women with unappeasable sexual appetites, while condemning as pathology any demands on adult men beyond those they were willing and able to satisfy. "Normal" female desires were satisfiable by vaginal orgasm in coitus on the husband's schedule. Needless to say, this model was a good fit to a minority of actual women. Men apparently liked to believe in the existence of nymphomaniacs as long as they did not have to have sex with one. Moreover, as Groneman points out, historically men have suspected women who were not satisfied with heterosexual intercourse of other kinds of trouble, including career ambitions and political activism (p. 58). While there are numerous references in this book to the relationship between the concept of supposed nymphomaniac insatiability and the relative ineffectiveness of coitus as a means of producing orgasm in women, there is no extended discussion of its significance to the development of the disease paradigm, which might have been illuminating. Groneman does give us a wonderful quote from Margaret Sanger about the "average man's sexual technique," which the famous sexual radical says is like "an orangoutang trying to playa violin" (p. 40), and she discusses the contributions of both Alfred C. Kinsey and William H. Masters and Virginia Johnson to the public debate on vaginal orgasm (pp. 89-91, 123-24). Groneman is definitely in her element in the chapter on "Nymphomania in the Courts" (pp.95-120), and in her later development of this topic as a modern legal and moral theme (pp. 174-79). The "diagnosis" of nymphomania was used from the turn of the nineteenth century until quite recently to undermine the credibility of charges of rape and incest on the grounds that nymphomaniacs typically and pathologically imagined sexual assaults and then made charges on the basis of their fantasies. Where sexual intercourse had clearly occurred, the alleged nymphomaniacs could be charged with inciting and consenting to sexual act, thereby invalidating a charge of rape and exculpating the defendant in incest cases. Even in the notorious Giles vs. Maryland case of 1961-1967, in which three young African-American men were accused of raping a sixteen-year-old-girl, the issue of the accuser's "promiscuity" and possible nymphomania affected the Supreme Court's eventual remand of the case to the Maryland Court of Appeals for retrial and the subsequent clearing of all three defendants. Groneman's book would have benefited from more depth of historical documentation prior to the nineteenth century, and particularly from a discussion of nymphomania's predecessor disease paradigms, among them "greensickness," hysteria, and so-called "widow's and nun's melancholia." There are also a few annoying minor errors, such as the reference to Richard von Krafft-Ebing's 1886 work, Psychopathia Sexua-
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lis (p. 29), as Psychologia Sexualis. Taken as a whole, however, this book is a valuable addition to the historiography of women's sexuality. RACHEL MAINES Cornell University Libraries MARK C. CARNES, editor. Novel History: Historians and Novelists Confront America's Past (and Each Other). New York: Simon and Schuster. 2001. Pp. 351. $26.00. This book follows Past Imperfect: History according to the Movies (1995), a volume in which sixty scholars and writers contributed essays about films that purport to represent the past. Mark C. Carnes conceived of that book as a way to explore the hotly contested boundary between fact and fiction, history and art. But he found that the differences in the values and vision of those who work with words and those who work with images resulted in a "fundamental disjunction of purposes." A historian might have a good reason to watch movies with a critical eye, but the exercise did not necessarily shed new light on the nature of history or art. So Carnes turned to the history in novels, asking twenty historians to write about twenty novels, from Gore Vidal's Burr (1973) to Tim O'Brien's In the Lake of the Woods (1994). Then he asked each of the (living) novelists to respond-hence the last three words in the book's subtitle. Readers who pick up the book hoping for combat will be disappointed. The historians are full of admiration, even awe. It is not simply that the novelists write so well; it is also that they know their subjects, characters, and scenes from the inside out. They have "the freedom," as John Mack Faragher says of Jane Smiley, "to imagine a past that is in some ways truer than history" (p. 147). Numerous historians identify instances in which novelists used that freedom to imagine facts, forces, and contexts years before historians managed to document them. The novelists are never less than respectful. They know that they live in a land where historians-in monographs, textbooks, popular histories, book reviews, op-ed pieces, documentaries, and even radio and television news-are widely considered to be the guardians, if not the proprietors, of the past. If blurbs on the backs of historical novels are any indication, many trespassing novelists take comfort in historians' blessings. Yet many of the novelists, themselves toilers in the libraries and archives, seem sincerely impressed by how hard historians work and how much they know. "It was clear," Madison Smart Bell writes of MichelRolph Trouillot, "that the author knew a hell of a lot more about the Haitian Revolution than I probably ever would" (p. 198). The volume is not entirely a love fest. James M. McPherson takes Russell Banks to task for numerous factual errors that do not contribute to his story. Banks responds, in one of the few replies that is longer than the original essay, with a lecture on the uses of fact in
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