Much recent interdisciplinary work in Victorian studies addresses the impact of medical and scientific progress on the cultural and social conditions of the period. Influenced largely by Foucauldian criticism, this research examines the rise of scientific and medical discourse and its relationship to the diverse literary and imaginative texts of the period. Most notably, critics including Gillian Beer, Lawrence Rothfield, Athena Vrettos, and Peter Logan have revealed that reading literary texts alongside scientific movements and discourses provides a richer and more historically accurate understanding of the cultural and social configurations of the nineteenth century. Janis McLarren Caldwell's book Literature and Medicine in Nineteenth-Century Britain contributes to this interdisciplinary body of work by reexamining largely canonical literary texts, including Frankenstein, Wuthering Heights, Middlemarch, and figures (Thomas Carlyle and Charles Darwin) against the backdrop of scientific inquiry and clinical medicine. Caldwell, however, shifts away from Foucault's readings of medicine and institutional power—which she argues provide limited images of medicine in the nineteenth century—and suggests instead that scientific knowledge and progress occurred alongside personal experience. Focusing on what she terms the “pre-Darwinian period” (1800–59) prior to the publication of the Origin of the Species, Caldwell examines a “double vision” that she terms “Romantic materialism” (1). She argues that Romantic materialisms “read the world through two books: the book of nature and the Book of Scripture” but “accepted disjunctions between two ways of knowing and called for interpretive method which tacked back and forth between physical evidence and inner, imaginative understanding” (1). Much of Caldwell's strategy is to examine this dualism to reveal how clinical medicine and imaginative literature were comprised and produced by the same cultural tensions and configurations.

Caldwell's readings of Carlyle and Darwin examine the dialectical tension of Romantic medicine in their philosophical development and help set up her framework within the larger history of ideas of the period, but the bulk of her book is comprised of readings of fiction. The book is framed by two of her strongest literary chapters. In her first, she addresses Frankenstein and suggests that although it is often read as a cautionary narrative, especially when it is examined in relation to biomedical knowledge and ethics, Frankenstein more importantly reveals the conflation of scientific and moral theory (29). It is here that Caldwell sets up the dualistic threads of the personal and scientific and the natural and material in late Romantic culture. She argues that the real ethical issue in Frankenstein is the redefinition of sympathy—through her reading of sympathy in the novel, she reveals how it was a contested term in the period, and one that carried multiple connotations and definitions; within the novel she suggests that sympathy is “both a natural, material principal and the highest ideal of social interaction” (29). Caldwell concludes that Shelley “invites the reader to a kind of sympathy based not on identification, but on active accommodation of difference” (45). In her final chapter, on George Eliot's Middlemarch, Caldwell provides her richest reading of medical culture in the Victorian period. In this chapter, which posits the literary text alongside medical texts and case reports, Caldwell offers a fresh reading of Eliot's novel and describes how the literary and medical overlapped in the formation of clinical medicine. It is here that her book really addresses what readers may assume from the title—this chapter engages with the literary and the medical cultures of the period, with the doctor/patient relationship, and with shifting balances of power in medical culture. By discussing the development of the medical practitioner through her analysis of Lydgate, and contrasting Lydgate's medical vision with Dorothea's Romantic faith, Caldwell suggests that Eliot “reminds us of an alternate meaning of ‘clinical,’ one lost, largely, to literary critics under the influence of Foucault” (170). Here Caldwell addresses Romantic medicine's attempt to balance patient narratives with scientific ones.

Some readers may find that her chapter on Charlotte Brontë is less convincing as an example of her larger argument; here she seems to stretch her critical readings of Villette and Jane Eyre to try to make them fit within the parameters of her book defined in the introduction and first chapter. In both her chapters on the Brontës Caldwell traces the relationship of the body and soul within the development of characters—she describes how an “inverted dualism of good body/bad soul permeates all of Charlotte and Emily Bronte's work” (81). Wuthering Heights is a better fit for her argument. Here she explores language and embodiment and focuses her discussion upon the framing of the novel and its representations of childhood; the child's body is thus “enshrined” (83) in the book. Caldwell argues further that Brontë's narrative replaces the authority of medicine—the doctor's authority is confronted by the power of the narrative tale.

Readers who hope to discover lesser-known Romantic and Victorian texts or analysis of the development of medical institutions and discourses in the nineteenth century may be disappointed by this work, since Caldwell's approach is sometimes limited by the dualistic model she applies to readings of well-known figures and texts. However, the book's chapters provide rich and close readings of nineteenth-century literature, and her responses to the large body of criticism in the areas of literature and medicine during this period are well developed. Caldwell's book successfully provides ways to examine complex questions of narrative in medicine and shifting ways that scientific knowledge was negotiated and understood. Her overall exploration of the balance between the material and physical is strongest when she describes the tensions between patient history and scientific knowledge; it is in these moments, particularly toward the conclusion of her book, that readers will notice the strengths Caldwell's own practical experience as both a physician and a writer bring to the text. Here the larger ethical questions surrounding medicine as a practice emerge, and one can sense Caldwell's commitment and engagement with a patient-centered model of medical practice that complicates the Foucauldian “clinical gaze” and makes it, as her readings conclude, incompatible with the medical culture of the period.