In Symptomatic Subjects, Julie Orlemanski illuminates the matrix of competing and entangled causes that medieval men and women negotiated, embraced, rejected, and experimented with when attempting to understand the workings of their bodies, the boundaries of the self, and the position of that embodied self within the cosmos. Orlemanski argues that by attending closely to the language of phisik in medieval writings and exploring how its etiological models collided with those of other discourses, we can better understand medieval comprehensions of the embodied self as a “symptomatic subject.” This term—which is fleshed out through sharp analysis of an impressive range of texts and genres—designates a physical body that simultaneously aligns with, exceeds, and complicates one's sense of self; that body demands and resists external interpretation in ways beyond any individual's control. Like many ideas developed in Symptomatic Subjects, this concept promises to prove indispensable for future scholarship engaged in understanding the relationship between self, community, and cosmos in diverse types of medieval texts.

Orlemanski's study builds on several strands of recent scholarship. As she notes, “scholarship on the body's history has excelled at reconstructing the somatic templates and disciplinary scripts of particular discourses—of chivalry, laywomen's piety, and medieval antisemitism” (279). However, the strength of Symptomatic Subjects is the way in which it considers multiple etiological models at once: medical explanations for the various signs that bodies display are shown to be in conversation (or conflict) with some of these other models’ interpretations. This means that “figures marked with leprous pustules, or the pallor of lovesickness, or lunacy's rolling eyes . . . inhabit a contentious hermeneutic circle that churns between competing systems of explanation” (3). Orlemanski also uses this etiological focus to extend a growing body of literary criticism dedicated to highlighting the reciprocal discursive exchanges that took place between medical, devotional, and literary writings from the late fourteenth century onward; this was the period when the vernacularization of medical texts afforded the language of phisik greater cultural prominence and circulation. Orlemanski is careful, though, to attend to medicine's simultaneous “prevalence and provisionality” (279), to the ways in which the language of medicine could remain other, unfamiliar, and suspicious to writers and readers. It is this provisionality, she suggests, that means that medicine frequently remains just one of many languages in a “churn of unreconciled discourses” (279).

Symptomatic Subjects uncovers how these discursive interactions play out in an impressive range of texts and genres. The first two chapters introduce the key medical models and ideas available to writers and readers when they acted as “bricoleurs of etiology” (3), deciding between, excluding, and piecing together diverse understandings of body and self. Then, in chapters 3 and 4, Orlemanski adopts a genre-based approach, analyzing how satire and exempla individually expressed uncertainty and anxiety about medicine's capacity to explain bodily “symptoms,” those corporeal markers demanding interpretation. Satirical rewritings of medical discourse such as Robert Henryson's Sum Practysis of Medecyne are shown both to rejoice in and rail against medical jargon's dual capacity to become, on the one hand, “pure sound” (or poetry) and, on the other hand, empty sound, noise that is as material and corporeal as the body it supposedly references (112). In both instances, medical jargon's capacity to describe and explain the body is questioned. Exempla are shown to open up similar interpretive cruxes for writers and readers. Like medical writings, exempla constantly negotiate the relationship between individual circumstances and general principles. Layering spiritual, physiological, cosmic, and social causes, they also confuse the legibility of bodily signs so that the spiritual and corporeal and the figurative and literal become difficult to equate or separate.

Orlemanski describes both exempla and satire in her introduction as intermediary “literary paths” along which medical discourse traveled “on its way into fictional narrative and poetry” (81). Although the exact nature of the genres’ in-betweenness could be fleshed out more, these chapters provide a useful conceptual bridge to the final four chapters, which explore how individual literary writers manipulated causal matrixes. Respectively, the chapters concentrate on Arcite's wounded body in Chaucer's Knight's Tale, Cresseid's leprous body in Robert Henryson's The Testament of Cresseid, Thomas Hoccleve's autobiographical and alienated self in the Series, and Margery Kempe's ruptured, roaring, and crying body. The discussion of Henryson's Testament helpfully illuminates one way in which the causal logic of exempla might be incorporated into, and further complicated by, fictional narrative. Furthermore, each chapter illuminates afresh aspects of texts that have incited much critical debate; Orlemanski deftly shows that this uncertain play of explanation is often part of the texts’ intended effect and part of a broader cultural understanding of the unstable, indeterminate relationship existing between bodies and selves.

The study raises plenty of questions for future scholarship. One issue that might be explored in more detail is how gendered medieval medical writings (such as gynecological texts and texts concerned with “the secrets of women”) interact with other discourses to confuse the legibility of female symptomatic subjects. How, too, do medical discussions of bodies associated with diverse races, religions, and nations interact with coexisting etiological models? Scholars might also think more broadly about the relevance of “bricolage” for medical discourse itself: moving beyond the conceptual focus of etiology, one could ask how else bricolage structured practices of medical reading and textual composition, since medical texts were themselves often piecemeal compilations of interconnecting medical and astrological models. What is clear, then, is that Orlemanski has provided scholars of all kinds of late medieval texts with a vital set of critical tools with which they might newly attend to the uncertain, plural, and fluid relationship between body, self, and other, and to the sustained medieval conversations that took place between literary and medical writings.