Fear in the Medical and Literary Imagination, Medieval to Modern: Dreadful Passions (Review)

In this post, Margarita Saona reviews Fear in the Medical and Literary Imagination, Medieval to Modern: Dreadful Passions (Palgrave Macmillan, 2018), edited by Daniel McCann and Claire McKechnie-Mason.


Fear in the Medical and Literary Imagination, Medieval to Modern: Dreadful Passions, edited by Daniel Mc Cann and Claire McKechnie-Mason, compiles ten chapters analyzing literary texts and other cultural products – from letters to TV series – loosely connected by the topic of fear. Each chapter presents a well-researched, well-written study of a particular topic that readers will find differently engrossing, according to each reader’s field of expertise. In that sense, it is a successful collection, in that it provides a wide range of approaches to the study of fear in Western (mostly English) culture. The essays themselves will be of interest both to specialists and to scholars of adjacent fields, who will find in them good models to examine the ways literature and culture shape and are shaped by medical discourses and practices. That this is a collection that studies different expressions of fear in medieval and modern discourses should be clear from the title, but readers who might expect a monographic review of the evolution of the concept will not find it in this book.


The compelling introduction by Daniel McCann and Claire McKechnie-Mason establishes the ways in which texts have defined the connection between fear and disease both in medical literature and in other forms of writing, from philosophy to fiction. They present a strong argument for the study of fear in its textual representations:

Narratives that represent or evoke fear can provide sophisticated cultural engagements that offer unique insights into the human condition through time. The essays in this volume explore the multivalent understandings of fear in a range of historical periods, and go some way to demonstrate the variety of responses it evokes in medico-literary contexts. (6)

McCann and McKechnie-Mason set the collection as an important contributor to the discussions arising from the medical humanities today: from the importance of affect in the practice of medicine, to the medical gaze, to the relationship between patient expectations and outcomes. They explain that they have organized the collection in two sections: the first section is focused on medical practices and the second, on the rhetoric of fear.



The first section, “Treating Fear: Medicine, Illness, Therapy”, starts with a chapter authored by McCann and entitled “Dreadful Health: Fear and ‘Sowle-hele’ in The Prickynge of Love.” As a guide for monastic contemplation, fear is in the text analyzed by McCann, a form of medicine that can save the soul, preventing sin, which is understood as a source of illness.  Mary Ann Lund’s fascinating chapter, “Without a Cause: Fear in the Anatomy of Melancholy” links fear to general anxiety and depression and examines the way Robert Burton’s famous treatise sees the imagination (when it produces delusion and anxiety) as having an effect on the body. Allan Ingram and Clark Lawlor study the evolution of fear and anxiety in the eighteenth century, from the religious fear of damnation to the modern sense of ‘spleen’ in “The Gloom of Anxiety.”


These three chapters, along with Pamela K. Gilbert’s “Dreadful: Aesthetic Fear in Victorian Reading,” provide a historical perspective regarding the sense of fear in British culture, from the dread inspired religious fervor in Middle English texts to the boom of fiction aimed at producing fear and sadness in Victorian times. The medical practices associated with the analyzed texts is not always evident, beyond a general connection between psychological states and what the medical establishment will see as maladies over the different periods studied in these chapters.


Joanna Bourke’s chapter, “‘Frightened and Rather Feverish’: The Fear of Pain in Childbirth,” focuses more on medical practices as it studies the evolution of anesthesia for childbirth in connection to both the medical discourses and the women patients attitudes toward pain from the 19th to the 20th century. Although fear is a factor in this study, the focus is more precisely on pain itself and on how a male dominated profession in many cases accepted or even promoted women’s pain as unavoidable or even desirable.


The second section, “Writing Fear: Rhetoric, Passion, Literature,” presents in the view of the editors a more strictly literary focus. This distinction is not clear in all the cases, but it is reflected, for example, in the lexicological study by Andy Orchard, “Fresh Terror, New Horror: Fear and the Unfamiliar in the Old English Exodus.” Orchard analyzes the abundance the richness of the language of terror in Old English, presumably responding to brutal invasions by Anglo-Saxons, Vikings, and Normans. The chapters by Elizabeth Hunter and Sally Shuttleworth on Elizabethan and Stuart Literature and on the Victorian psyche, however, could have been paired with the chapters of the previous section, in which the literary and generally textual manifestations of fear respond to the ways societies of those periods conceived the relationship between dread and illness.


The two last chapters belong to the realm of cultural analysis more than to literary or linguistic studies. Neil Pemberton’s chapter, “The Mass Dread of Quietude and the British Anti-Noise crusade 1919-1939,” singles out the fear of silence as an effect of mass culture and explores the campaign against noise as a reaction of Britain’s elites to modern masses. Martin Willis presents a very compelling reading of the “case report” genre in TV dramas and in the medical journal The Lancet at the end of the 20th and the beginning of the 21st centuries in “The Fearful Body in Contemporary Medical Television Drama and Medical Case Reports.” Willis observes how in shows such as ER, House, M.D, and Critical, bodies become more and more a case to be solved than an individual who needs healing. The topic of fear (of the sick body more than the frightened body) is present in the chapter, but seems less developed than the excellent analysis Willis does of the general evolution of the medical drama genre.


Fear in the Medical and Literary Imagination closes with a beautiful piece by Priscilla Ward on the concept of the uncanny and the disturbance of identity as a primal fear. Ward also touches briefly on the different chapters in the book and how they relate to a possible fear of one’s own non-existence.


As a collection, Fear in the Medical and Literary Imagination, Medieval to Modern provides the readers with studies that go deep in the analysis of different manifestations of fear and their potential connection to medical discourses and practices. Reading some of the chapters in connection to one another also presents the evolution of the term from religious understandings of dread to contemporary medical practices. This collection should be an invitation to more studies that promote an understanding of how fear might impact health and the medical interaction with bodies and minds.



About the Reviewer:

Margarita Saona is the head of the department of Hispanic and Italian Studies at the University of Illinois at Chicago. Her work focuses on issues of gender, identity, and memory in literature and the visual arts. Among her publications are Memory Matters in Transitional Peru (Palgrave, 2014) and Corazón de hojalata/Tin Heart (Pandora Lobo Estepario, 2017).

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