In 1793, young medical student James Williams writes home: “My room … is not the most pleasant in the world. … The Dissecting Room with a half dozen bodies in it is immediately above … you may conceive it to be a little perfumed. There is a dead carcase just at the moment rumbling up the stairs” (104). But James ends his letter, “There is something horrible in it at first, but I am now reconciled” (123). Young James's letter encapsulates the question that underscores this book: So how did James reconcile with the horrible aspects of medicine? How did young James become dispassioned?

With Words and Knives discusses “how medical practitioners wrestled with their emotions and those of their patients through an examination of training, especially in anatomy, from 1600–1800 England” (4). Lynda Payne's title emphasizes her attention to the medical training, the use of knives on patients, both living and dead, and the many forms of writing that went into and came out of their medical training, the use of words to describe a complex set of emotions and feelings and all that practicing medicine meant.

Payne organizes the book chronologically, with a chapter devoted to each of her six case studies: William Harvey, Walter Charleton, John Ward, Daniel Turner, William Hunter, and John Hunter. This organizational strategy helps to show the history of anatomical training as well as to highlight the continuity of the training, with each doctor encompassing parts of his forebears.

Chapter 1 begins with William Harvey. In it, Payne systematically walks the reader through Harvey's training, paying particular attention to the influences that may have led to his emphasis on dispassion. Payne suggests that Harvey's training, particularly his time in Padua, helped him focus on the skills needed to be a good anatomist: a good sense of observation; the ability to speak clearly of his findings; mental acuity to connect what was seen to what was known (and unknown). At no time in his training or in his practice did Harvey become emotional. He practiced what he was taught—to learn from the body and not be affected by it.

Payne's next subject is Walter Charleton, whom she uses as an “intellectual barometer of his age” (38) in an attempt to theorize what he and his contemporaries were reading and reacting to and against. Here, Payne spends a considerable amount of time in close readings of three of Charleton's works: a romance, his college lectures, and a meditation on the passions themselves. The interest here is to track his references and interpretations of the passions. Payne concludes that Charleton's work was meant to help educate students that understanding the passions was the key to self-knowledge and self-control. However, Payne's analysis fails to show how Charleton is symbolic of the “philosophical and emotional underpinnings of the medical community” (38).

Chapter 3 looks at the life of clergyman John Ward, who over a period of thirty-three years wrote in his commonplace books his participations and observations of dissections, operations, autopsies, and his ministering to the sick. Through Ward, Payne attempts to show what resources medical men had to help them cope with the distress of witnessing the suffering of the sick. Payne concludes from Ward's writing that he drew on his experiences with the professional world of medicine and his domestic role because “one enabled him to view the body as a place of learned knowledge, the other to see the body as a locus of mundane and measurable activity” (73).

Up to this point, Payne's case studies have primarily dealt with the anatomist, those who worked and learned from the dead. In chapter 4, Payne moves to trying to understand how future medical men were prepared for “inflicting pain in an attempt to heal a patient through cutting, blistering, or amputating” (84). Daniel Turner, an expert on venereal disease, advocated that his patients be honest, obey his instructions, and be stoic throughout treatment. His extant writings reflect his patients’ difficulty with each in varying degrees and his response to them. However, Turner's case histories adequately show how one doctor treated and reacted to his patient's pain and suffering.

Payne is especially engaging and enlightening in the last two chapters on William and John Hunter. Because the brothers were opposites in many ways, the juxtaposition of their histories makes for a compelling story. William Hunter was the esteemed lecturer in anatomy and surgery and was frightened, to the point of passing out, of surgery. On the other hand, John was a noted surgeon who hated to lecture, most probably due to stage fright. William prided himself as a gentlemen and an educated teacher, while John was often coarse and relished his “lack of genteel learning” (108). However, the brothers “were amongst the most famous medical men in Enlightenment Europe” and “were responsible for educating most of the next generation of leading physicians and surgeons” (104).

William Hunter tried to teach his students that anatomy helped doctors familiarize their hearts with a “necessary inhumanity” needed to perform. William had students first observe their own bodies and then slowly eased them into the dissecting by showing them preserved parts. “From the beginning of the course, thus he attempted to consciously reign in their passions” (111). For John Hunter, his experiences as a body snatcher illustrate his dispassion as he was primarily responsible for obtaining the necessary flow of dead bodies needed in a teaching school. John's experiences as an army surgeon also helped him learn and teach dispassion. William's lectures and John's performance in the dissecting room were handed down to their students in a systematic and dispassionate fashion, which continued the “necessary inhumanity” of anatomy and surgery.

While Payne does an admirable job of making her six case studies interesting, the reader is forced to make too many of the major connections between them and the primary question of how medical men dealt with their emotions. In other words, each chapter reads as an independent narrative, a minibiography, rather than an interwoven argument that explains fully the “emotional communities” these men were part of and how those communities helped them learn dispassion.

Moreover, another area remains sorely underdeveloped in With Words and Knives, a more intimate connection between the theoretical models that influence the passions or dispassions of doctors briefly discussed in chapter 2 and an engagement with literature on the passions. The theoretical connections hinted at in chapter 2 needed to be interwoven and expanded throughout the book, which would help with making the connections between the case studies and the context of the period. And although this study claims to explore the “dispassions” of medical men, its limited references to primary materials on the passions or the emotions and to the ever-expanding secondary scholarship on early modern passions and how passions were perceived and acted upon seem to be a significant shortcoming. Even with its shortcomings, the book provides valuable insights into the training and practice of medical men and it would be a complimentary text to other work on practitioners and medical education in early modern England.