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Mark Twain and Medicine: "Any Mummery Will Cure"by Ober, K. Patrick
Publisher: University of Missouri Press
Retail Price: $47.50
Issue: Winter 2005
Bizarre beliefs on health and healing
Why did America's 19th century master of satire repeatedly play the boob when he sought medical help? How was the creator of the Connecticut Yankee (who exploited the cupidity of an entire empire) duped by the medical confidence men of his era? K. Patrick Ober, an internist and associate dean at Wake Forest University School of Medicine, takes on this knotty problem in Mark Twain and Medicine: Any Mummery Will Cure. As much a history of medical sectarianism as an extended chart on Samuel Clemens, wife Olivia Livy Langdon, and daughters Susy, Jean, and Clara, the book joins a growing list of medical biographies that illuminate the complex intersections between physicians, medical subjects, and 19th century beliefs about illness and cure.
A self-proclaimed Twain buff (he calls himself a Huck Finn addict), Ober probes Clemens's lifelong preoccupation with medical therapeutics and insists that we cannot fully know the man who was Mark Twain without considering Clemens's representations of psychological and physical health. According to Ober, the medical life offers insight into the Clemens/Twain dichotomy by revealing the man's frustrations with contemporary medical practice and the distillation of that critique into every aspect of Twain's literary work. Ober has examined 59 of Twain's novels, stories, speeches, letter collections, and autobiographical writings for their medical references--a daunting task--notwithstanding scores of books about Twain. The bibliographic richness of the text is also apparent in the contextual descriptions of allopathy, homeopathy, osteopathy, hydrotherapy, and every other cure Clemens seized upon and later rejected.
Ober punctuates the Clemens medical saga with stories and beautiful photographs of trusted family physicians like John Brown of Edinburgh and Livy's midwife Rachel Gleason. He also reports on more colorful medics like gun enthusiast Joseph McDowell, whose fortified St. Louis medical college ultimately became a Union military prison when the doctor fled to Memphis to join the Confederate army. We are reminded that the fictional Colonel Sellers, a con man and purveyor of patent medicines in The Gilded Age (1873), touts his friendship with the flamboyant, real-life doctor--a connection that underscores the impression that medical practitioners had on young Sam Clemens. The stuff of biography inevitably surfaces in the fiction as neurosis. An early bout with measles, fear of scarlet fever, and the death of brother Benjamin when he was six all find their way into The Adventures of Tom Sawyer (1876), where, in Ober's analysis, medical knowledge becomes a destroyer of childhood innocence.
At once true believers and skeptics, the Clemenses toyed with patent medicines in the 1860s and subjected themselves to the rigors of hydrotherapy in the 1870s--a regimen that included ingesting quarts of salt water and allowing themselves to be wrapped in wet sheets to cure their colds. When homeopathic cures gained a foothold later in the century, Clemens fasted to relieve his nasal symptoms. In the 1890s, when he could find no relief for his chronic gout, Clemens sought the services of an electrotherapist, whose shock treatment gave him but temporary peace. Writes Ober on page 142, It should have been apparent to Clemens that electrotherapy was just another version of patent medicine and water cure, perhaps more updated in its terminology but every bit as useless in its effectiveness. The author does not seek to answer why it was not apparent, though he does suggest that the episode taught Clemens about hope--a spiritual commodity more precious than relief.
We also learn about the Clemens family's preoccupation with mind cure in the 1890s, when Susy, Livy, and Sam all believed that their vision could be corrected by the power of positive thought. Sam even resorted to hiring a Dr. Whipple whom he believed cured him of bronchitis by watching him pace. Enthusiasm for therapies like mind cure resulted from medical steps and missteps in earlier decades. Livy's own miracle cure as a teenager figured largely in this psychic evolution: After an icy fall in 1862, the young Miss Langdon took to her bed for two years with paralysis until faith healer J.R. Newton helped her snap out of her lethargy (and presented a bill for $15,000!). Sam's marriage to Livy required a sort of medical indenture, where Livy sought treatment from promising but distant doctors while Sam watched closely over his wife's delicate health. Ober's sketch on neurasthenia demonstrates how American doctors manufactured the condition as a catch-all for female complaints, but he might have taken the gender analysis further to uncover its class dimensions: elite women like Livy Clemens were susceptible to the fashionable diseases because they had both the money and leisure to attend to their bodies (Douglas, Ann. The Fashionable Diseases': Women's Complaints and Their Treatment in Nineteenth-Century America, Journal of Interdisciplinary History 4: 25-52.). More to the point, the Clemenses were able to dabble in every popular form of 19th century medical treatment precisely because they were rich; they were acting as consumers to a medical establishment sustained by the disposable income of the well-heeled.Though bodily infirmity kept the Clemenses in a state of perpetual anxiety, Sam came to realize that spiritual illness was far more debilitating. Ober regards the distinction between disease (of the body) and dis-ease (of the spirit) as central to Twain's creative drive. His discussion of the placebo effect and its homeopathic utility encompasses the last third of Mark Twain and Medicine. As homeopathic medicine eclipsed the popularity of allopathic practice, the Clemenses sought cures that placed increasing emphasis on the patient's psychological participation or exclusion. When daughter Jean contracted pneumonia in 1902, physicians and family conspired to hide the information from Livy--even to the point of censoring her mail--believing that they had prolonged her life by leaving her out of the medical loop. Christian Science was no match for Susy's meningitis in 1896, however. Clemens blamed himself for waiting too long to bring in doctors, though once the condition could be diagnosed, it was already too late to save the patient. In these examples, Ober observes on page 205 the dissonance between truth and hope (the former reveals the severity of a case while the latter conceals it), and concludes that, for Clemens, the patient's faith in a treatment improved the chances of recovery even if the disease pattern [had] nothing at all to do with the therapy that [was] administered.
No reader will come away from Mark Twain and Medicine without a sense of the heady decision-making that faced citizens in a world of competing medical therapies. That said, the organizational scheme of the book could be more streamlined. Though the chapters roughly adhere to a chronology, we do not get the complete details of the family medical history until Appendix 1--material that might better be assimilated into the introductory chapters. Twenty-two chapters, some of which feel too short, meld Clemens's biography with the history of medicine but sometimes lose the thread of the narrative. In Scarlet Fever Will Be True to You and The Cholera Days of '49, Ober recounts public fear of the epidemics in Missouri and describes allopathic blood-letting and cupping without returning to Clemens. Ober does suggest that fear of contracting these diseases dogged the author, but he misses a golden opportunity to illustrate how Clemens's developing ideas about disease evolved with his literary output. It might be argued, for example, that the sentimental feel of Tom Sawyer and Huck Finn gives way to a flinty cynicism by the time Twain pens The Mysterious Stranger and Letters from the Earth at the end of his life; that his pessimism at the deaths of two of his daughters and his wife, not to mention his poor financial judgment, forced his muse down some impenetrable shaft.
It is not clear why Ober separates chapters five and six on patent medicines. In the latter, a discussion of Twain's crusade to discredit vendors falls short: a passage from Tom Sawyer is cited without any larger cultural critique of confidence men, which would give the reader a better sense of why Ober thinks such passages are important. This pattern of argument--where the author identifies a medical phenomenon from Clemens's life and then cites a passage from the literature without adequate explication--is disappointing because broader cultural strokes are lost in the welter of details. Though Ober does not claim to be a cultural critic, the most compelling conclusions drawn in interdisciplinary studies like this one are cultural: Yes, Clemens's willingness to believe in the tenets of every medical care sect that came along and to embrace them with unrelenting enthusiasm . . . was a mark of the man (p.104), but the evidentiary aspect of such claims could be more carefully delineated. Ober speaks intelligently about Clemens's faith, resilience, and impatience, but he does not draw out the psychological implications of these qualities. The premise of the book's subtitle, that any mummery will cure, bespeaks the magic bullet that Clemens sought in vain. Latching onto medicine as a belief system worth investing in is fertile interpretive ground that Ober avoids. Indeed Clemens's medical fervor marks the transformation under way in the second half of the 19th century from belief in things religious to a more secular construction of society--a passing observed and lamented by the likes of Henry Adams in The Education, Harold Frederick in The Damnation of Theron Ware, and Twain himself in A Connecticut Yankee.
On balance, Mark Twain and Medicine is written for a medical audience. Though it catalogues the literary references Twain made to the Materia Medica of his own life, it does not fully enough relate those references to a cultural critique of the period. In this sense, students of literature and history may see what made Twain a source of endless fascination for Ober but not what made him an icon. Ober's strengths lie in deciphering the medical codes that permeate the Twain canon and in extracting the philosophical positions that Clemens embraced on his medical journey. This perspective will contribute to our understanding of 19th century medical lives, but it is less certain whether Mark Twain and Medicine will make an enduring mark on Twain studies.
Jane E. Schultz is Associate Professor of English, American Studies, and Women's Studies at Indiana University-Purdue University-Indianapolis. She recently published Women at the Front: Hospital Workers in Civil War America (Univ. of North Carolina, 2004) and is finishing work on This Birth Place of Souls: Harriet Eaton' s Civil War--an annotated edition of one of the last remaining unpublished Civil War nursing diaries.