I: Making the Human with Language(s) and Literature

Modern conceptions of the human hardened from the mid-19th century. As medicine became professionalised in Europe, the human subject was regulated through taxonomies that reified the concept of the ‘natural’ and conflated the social, cultural, and the biological. If the systematisation of medical knowledge theorised the ‘ideal’ human, it also produced the idea of the ‘pathological’. Individuals who did not fulfil this Western European bourgeois definition were categorised as ‘abnormal’. In France, correspondingly, the term ‘normalité’ [normality] first appeared in 1834, developing into ‘normatif’ [normative] in 1868, while the normative sciences appeared in Germany at the end of the 19th century (Butler, 2004: 49). The body—material and metaphorical—became a means through which a society manifested itself, and sickness and health became indices through which socio-cultural concerns were expressed. As Elizabeth Grosz observes, far from being an inert and passive term, the body is, instead, the crucial term and the site of contestation in a series of economic, political, sexual, and intellectual struggles (1994: 19).

It is the ‘pathological body’ in its widest sense that is the focus of the six articles in this Special Collection, which takes a medical humanities approach to the literary depiction of the body. Ranging from the 19th to the 21st century, and across four languages—Italian, German, Spanish, French—the essays focus on how the human body is the locus of socio-cultural anxieties and is therefore the privileged object through which society and culture(s) may be understood. From the rise of medicine, there was a close relationship between the literary and the medical as doctors and scientists used literature and its narrative-weaving capacity to promote medical ideas. Indeed, scientific claims are themselves narratives (Engebretsen and Baker, 2022: 2). Medical theories were, then, as much a derivation of narrative as of medicine, so the ‘pathological’ is dangerously influenced by socio-cultural bias. As literature and science both contribute to and draw upon the same ‘culture medium’ (Laura Otis, as quoted by Novillo-Corvalán, 2015: 6), the medicalised body should always be regarded as the socio-cultural body. The Collection contributes to the increasing Modern Languages interest in medical humanities, which has hitherto been dominated by the Anglosphere and Anglophone texts. This Introduction is a reminder that the authority of 19th-century Western medicine was Europe-wide, and its legacies have spread around the globe. Ongoing scholarship in non-Anglophone medical humanities is, therefore, vital. As many influential medical theories originated from Germany or France, for example, the multilingual expertise of language(s) experts is invaluable. The resources that language(s) specialists in the medical humanities can provide are manifold: skill in literary analysis of novels and other literary genre, linguistic proficiency that includes the ability to read medical texts and theorists in the original language, and historical knowledge. All these capabilities help us understand the shaping structures of gender, race, and class with their panoply of health implications. The history of medicine correlates with the history of literature in 19th-century Europe, therefore this Collection is an acknowledgement of the long historical tail preceding Modern Languages literary medical humanities.

As the articles demonstrate, literature is a different form of knowledge-making from that of medical science, and analysing the ‘pathological’ body in literary texts allows access to the non-normative and marginalised. Laura Otis’s observation is valuable in underlining the benefits of reading literary works through a medical humanities lens: literature as a site of knowledge becomes clear in the German terms ‘Literaturwissenschaft’ [‘literary scholarship’ or ‘literary science’] and ‘Wissenschaftsgeschichte’ [‘the history of scholarship’ or ‘the history of science’], which share the core idea of ‘Wissenschaft’ [the production of knowledge through rigorous research] with ‘Naturwissenschaften’ [natural sciences] (2010: 570). By contrast, in the English language, ‘literary studies’ and ‘the history of science’ are seemingly unrelated (570). Both fields use narrative, metaphor, and language (570), and 19th-century medicine used these facilities to construct a compelling account. As the articles in this Collection show, literature provides a space to ‘write back’ against some of the long-standing medical theories that have constructed the ‘natural’ and the ‘normal’ that are still globally prevalent today. The articles reveal the fabricated nature of ‘nature’, a medical template that can bind people and groups to an identity that has often been imposed violently upon them.

Literature uncovers how the modern body has been defined by medicine, and a study of its historical formation can shed light on increasingly polemical attitudes to the body today. By creating a coalition of literatures across non-Anglophone languages, it is possible to see how this plays out across different national contexts. In a recent publication promoting languages study as being key to transnational cultural enquiry, Jennifer Burns notes that the contours of the human is gaining new urgency in the 21st century across disciplines and the expertise of Modern Language experts, in particular, may prove essential in formulating how language makes and unmakes the human (2022: 141). In the context of a truly global medical humanities that understands health and the body, Steven Wilson underlines the vital importance of language(s) (2020).1 The medical realm materially shapes people and their identities, but there are inevitable blind spots. It is therefore an ethical imperative to highlight any injustice that ensues. As work by scholars of the history of medicine and science demonstrates, ‘no diagnosis is … unproblematic or freed from social and cultural issues’ (Lennard Davis, as quoted by Schalk, 2018: 63). If literature can deconstruct problematic medical narratives, it becomes an activist tool, and would be part of the mission of critical medical humanities to remake medicine in order to transform the wellbeing of individuals and society (Viney, Callard and Woods, 2015: 3). Modern Languages can make a valuable contribution to this undertaking. As Şebnem Susam-Saraeva and Eva Spišiaková note, health is too important to be entrusted solely to doctors and healthcare professionals (2021: 1). In this regard, Karen Thornber promotes ‘global literature’ (as opposed to world literature) as a tool in the ‘real’ world that can tackle global challenges by potentially influencing policymakers and others to enact the changes that would improve the wellbeing of a society and its citizens (2020: 10, 6).

To complement literary Modern Languages as a medical humanities resource, the work of translators is crucial. Translation work is a ‘trangressive’ practice as it creates new sites of knowledge production, and this becomes of utmost importance when it is possible to see how gender, for instance, is inscribed in a language and culture (Spurlin, 2014: 204, 206). As ‘different languages draw on different wor(l)ds’, the complexity of humanity becomes more evident beyond a monolingual world (Elsner and Wilson, 2022: 427). The practice of translation is, additionally, indispensable for justice for anti-racist, postcolonial, and anti-imperial issues, all of which are integral to medical humanities as they have strong links with the history of medicine (de Lima Costa and Alvarez, 2014: 557–58). Rosi Braidotti observes the need for ‘transversal alliances’ between different types of experts in elucidating the historical embeddedness of ideas, which is an exercise in ‘becoming polyglots’ that de Lima Costa and Alvarez suggest could provide a way to decolonise knowledge (561). While Braidotti’s hypothesis is in the context of feminist theory, the creation of networks between languages and their literatures would be equally valuable for critical medical humanities. It is in support of the capacity of translation to expose the influence of medical theories between cultures that the articles in the Special Collection give quotations in both the original language and in English translation.

II: Medical Legacies of the 19th Century

The 19th century was the golden age of clinical medicine, with the new scientific disciplines of physiology, pathology, and pharmacology flourishing in Berlin and Paris in the 1820s (Weatherall and Weatherall, 2003). In France, surgery became an academic discipline in the 1850s through the establishing of institutional chairs, and the ‘three As’ arrived: anaesthesia (1846); antiseptic (1869); asepsis (1886) (Ulrich Trölher and Adrien Pozzi, both as quoted by Tron-Ymonet, 2020: 383).2 Nineteenth-century European medical schools were all-male institutions (Callen, 2018: 76), and by 1900 there were still only 30 women doctors in France (Mesch, 2003: n. 3, 338). This, inevitably, led to a ‘masculinization of knowledges’ (Elizabeth Grosz, as quoted by Karmakar and Sarkar, 2021: 499). Nineteenth-century hygiene manuals delineated clear sexual roles, maintaining that it was only within marriage that women’s sexuality should be expressed through procreation (Mesch, 2003: 329). The legal realm acted in tandem with the medical sphere, and France passed laws between 1874 and 1919 to encourage women to stay at home as mothers (Freebody, 2023: 268). The institution of the family was the symbolic locus of society’s fundamental order (Pick, 1989: 73), so it was protected by medical, legal, and political regulatory frameworks.

With the rise of medicine, masculinity, or healthy manliness, became a physical and moral imperative in the 19th century (Callen, 2018: 78). In France, ‘healthy’ became synonymous with the ‘civilised’ (normal) male body (25); masculinity was considered a fact of nature and was also linked with rationality by specialists in mental medicine (Hewitt, 2020: 3, 2). In 19th-century Germany, similarly, maintaining an ideal of masculinity was thought crucial for a healthy nation (Mosse, 1982: 227). The Western European ideal of manhood enlisted institutional, social, and cultural factors to undergird itself. As Elisabeth Badinter notes, virility must be ‘made’ (as quoted by Áine Larkin, 2021: 88).3

The link between healthy manhood with a healthy nation is crystallised in the 19th-century condition of spermatorrhoea, the excessive discharge of sperm, which emerged in the 1840s and disappeared at the fin de siècle (Stephens, 2008: 201). Understood as a disorder of the reproductive system (201), it was a product of the social imaginary that saw it as a danger to a civilised social order (202). The 19th-century category of ‘woman’ was equally infused with social anxiety. This was demonstrated by French wax medical Venuses that showed the female body fluctuating between the real and the ideal, and sickness and health (Hunter, 2008: 43). The medical Venus improved medical knowledge, but they conceived of female sexuality as sick bodies in need of fixing (55). Nineteenth-century patriarchy linked the uncontrolled female libido with prostitution, which was a threat to the family and nation because of sexually transmitted disease (Callen, 2018: 112). Left unchecked, it was akin to bestiality, which set it on the same level as the lower classes, criminals, and non-white populations (112). Hysteria was the counterpart of spermatorrhoea, as the failure to adequately perform prescribed gendered behaviour. While some men were diagnosed with it, hysteria was considered a ‘humiliatingly female affliction’ (Elaine Showalter, as quoted by Callen, 2018: 127). After Jean-Martin Charcot’s arrival at the Paris hospital la Salpêtrière in 1862, hysteria transformed from being an illness that was caused by a woman’s ‘wandering womb’ to being a diagnostic category (Stephens, 2008: 206). Its symptoms included paralysis, muscle contracture, convulsions, and somnambulism (206). These convulsions represented a lack of physical control and also an unrestrained sexuality more usually associated with masculinity (207). Charcot commissioned a series of photographs of his patients experiencing hysterical convulsions (207). Importantly, these highly sexualised images did not record a pre-existing illness, but invented the condition of hysteria by constructing it through visualisation and narrativisation (207). Charcot’s influence was very widespread, reaching well beyond the medical profession. Contemporaneous accounts confirm that attendees of his famous Tuesday lectures came from the literary, artistic, and political spheres, and was an often international audience of medical and non-medical intelligentsia (Callen, 2018: 112–13).

The 19th century saw burgeoning medical fields across Europe investigate every aspect of the human body, and this created a hierarchy of humanity. In 1863, the French neuroanatomist Paul Broca published his work on the asymmetry of the human brain (128). Men were believed to have larger left brains, which were associated with intelligence, articulate language, morality, and reason, while women supposedly had more developed brains on the right-hand side, linking them with the emotions, instincts, criminality, and insanity (128–29). Broca, who founded the French school of anthropology in 1861, believed his discovery provided a new means of evaluating ‘different classes of humanity in the natural scheme of things’, which could be done through researching brain development according to race, class, and gender (129). The Italian criminologist and professor of psychiatry Cesare Lombroso placed the working-class man on the same medical level as the feminine and, hence, to the emotions, and positioned him within criminal anthropology as closer to the ‘primitive’ (128).

The failure to live up to the 19th-century medical imperative to be a fully procreative man or woman with normative desires bore profound consequences for subjecthood. As Judith Butler notes, being outside of the ‘exclusionary [heterosexual] matrix … requires the simultaneous production of a domain of abject beings’ (Halsema, Kwastek and van den Oever, 2021: Introduction, 11). From the 1870s, the study of homosexuality in France was conducted through the emerging medical fields of criminology, forensic medicine, and psychiatry, which eventually formed the discipline of sexology (Schultz, 2008: 176). Specialists catalogued a range of sexual pathologies, which they agreed were either hereditary or acquired through vice. In his authoritative study of sexual pathology, Psychopathia sexualis, published in German in 1886, the Austrian neuropsychiatrist Richard von Krafft-Ebing described the difference between the two as being either ‘a pathological perversion or a moral perversity’ (as quoted by Schultz, 2008: 176). Doctors conceived congenital inversion as a symptom of degeneration and hereditary process of decay, and its extensive mental and physical symptoms included suicidal thoughts, hallucinations, epilepsy, vertigo, stuttering, infertility, and even constipation (177). Concurring with Foucault’s perception that, from the 19th century, ‘deviance’ inscribed itself on the exteriority of the body (Stephens, 2008: 203–04), inversion could also include skull malformations, facial asymmetry, hernias, and even attached earlobes (Schultz, 2008: 177–78). Krafft-Ebing linked the apparent increase in homosexuality to moral decadence, whilst Julien Chevalier, a French forensic doctor and the author of L’Inversion sexuelle [Sexual Inversion] (1893), one of the first extensive treatments of homosexuality in France, blamed bohemian extravagance and the loss of middle-class values (179).4

The influence of 19th-century European medical discourse was global. Between 1870 and 1914, as debates about race and racial origins grew, theorists began distinguishing Europeans from peoples of other continents. This led to the rise of new fields such as phrenology, eugenics, ‘racial science’, and degeneration theory (Neill, 2012: 4). Scientists combined physiognomy, or the reading of character and emotions from physical features—especially facial—with other skull studies like phrenology to create the pseudo-science of craniometry. This practice of measuring skull size, shape, and brain volume was used to prove the superiority of white male Europeans, and was used to justify colonial ventures (Callen, 2018: 164). Tropical medicine practitioners advanced the racialisation of medical discourse by emphasising biological differences of Europeans from peoples in the tropics (Neill, 2012: 4–5). The German biologist and philosopher Ernst Haeckel formulated evolution as a straight line, where the unicellular organism was at the ‘bottom’ and the human being at the ‘top’, particularly the European male. Those who deviated from this line of development represented lower forms of life (Otis, 1994: 39).

The concept of the evolutionary straight line is evoked by the philosophers Sylvia Wynter and Denise Ferreira da Silva, who argue that the category of ‘Man’ refers to bourgeois Western whiteness, and racialised modalities of the human are mere derivations (Yao, 2021: 4). The supposed lower human status of non-white people dehumanised them, and was exemplified by the ‘Hottentot Venus’. This was the stage name of an African Khoekhoe woman whose colonial name(s) was Sara (Sarah/Saartjie) Baartman; she had been brought to Europe from the Cape in 1810 and was exhibited in fairs as an exotic ‘freak’ (Mattoscio, 2017: 57). The French naturalist and zoologist Georges Cuvier dissected Sara Baartman’s corpse after her death in 1815 to attempt to prove his thesis that a biological hierarchy of human races existed whereby the Khoisan were at the lowest level, making them closer relatives of the great apes than of humans (57–58). Cuvier’s findings were published in a book by Georges-Frédéric Cuvier and Geoffroy Saint-Hilaire titled Histoire naturelle des mammifères [Natural History of Mammals] (1824), in which Sara Baartman is always referred to as an ‘animal’ (n. 4, 59). In 20th-century France, colonialism was medicalised by psychiatrist Frantz Fanon in Peau noire, masques blancs [Black Skin, White Masks] as being ‘psychopathological’ (Megan Vaughan, as quoted by Nayar, 2013: 42), in producing disturbances in the coloniser and colonised. Reminiscent of 19th-century medical discourse, Fanon notes that white psychiatric practices often diagnose colonised Africans as ‘hysterical’ (75). Correspondingly, Edward Said describes the Oriental person as ‘something one studies and depicts (as in a curriculum) … something one illustrates (as in a zoological manual)’ (Edward Said, as quoted by Ashcroft and Ahluwalia, 2008: 61).

III: Literature and Science: A Shared Language

In the mid-19th century there was a shared common language and literary discourse between scientists and writers, which was readily accessible to readers without a scientific background (Beer, 2000: 4). Literary texts were viewed by authors and readers as ‘scientific’ (Kelly, 2007: 5). Scientists drew openly upon literary, historical, and philosophical works to form their arguments, including the French physiologist Claude Bernard who cited the German poet Johann Wolfgang von Goethe repeatedly (Beer, 2000: 5). While language ebbed and flowed in both directions between literature and medicine in this period, the strongest influence was of medicine on literature (Mary Donaldson-Evans, as quoted by Wilson, 2020: 30). Many authors had personal and professional connections to the scientific world. In France, Honoré de Balzac corresponded with the naturalist Geoffroy Saint-Hilaire; Gustave Flaubert read the works of his naturalist friend Félix-Archimède Pouchet; Auguste de Villiers de l’Isle-Adam was friends with scientist and poet Charles Cros; and Émile Zola corresponded with scientists in his meticulous research for his novels (Kelly, 2007: 6). Dissection had a special status in 19th-century French medicine (6–7). This became incorporated into the style of realist writers of the time, which seemed to carve and lay out reality piece by piece in its aesthetic bid for objectivity and truth (7). Critics claimed that Balzac’s works were written as if he were ‘like an anatomist’ (Bernard Weinberg, as quoted by Kelly, 2007: 7). For Zola, his Naturalist Rougon-Macquart series of twenty novels dramatised the body in a forensic style that moved well beyond Realism.5

Just as novelists incorporated medical ideas in their work, 19th-century European scientists used literature to bolster their scientific data. In his classic work on degeneracy and atavism, L’uomo delinquente [The Criminal Man], published in Italian in 1876 and attaining five editions, Cesare Lombroso proposed that criminals be studied as a separate race. Lombroso’s study became the central text in the growing field of criminal anthropology (Otis, 1994: 50). He took great care in noting the physical characteristics of the subjects he studied: the shape of the skull, nose, ears, eyes, jaw, and colour and quality of the hair. Despite attacking novelists such as Zola for their apparently irresponsible use of criminal physiognomy, Lombroso himself used anecdotes from literature to support his scientific claims (51). In constructing his case histories, Freud, similarly, took literary inspiration by adopting some narrative conventions of the 19th-century novel, especially using marriage as closure for female patients (Susan Katz, as quoted by Showalter, 1993: 27). For Freud’s male patients, however, their case histories resembled open-ended modernist fiction (32).

Literature itself was considered to be a medical document in the 19th century. The ‘pathography’ was a sub-genre of the medical thesis, especially in Lyon, France, where medical students wrote theses on Russian, German, French, American, and English men of letters—examples of which were Alfred de Musset, Fyodor Dostoyevsky, Edgar Allan Poe, Gérard de Nerval, Thomas de Quincey, and E T A Hoffmann (Marquer, 2020: n. 8, 9–10). The students quoted from the literary works, and used these extracts as medical evidence of symptoms of the literary authors’s mental state (2). Lombroso, too, converted poems by Charles Baudelaire into clinical documents (3). Similarly, in Entartung, published in German in 1892, physician and arts critic Max Nordau developed the technique of pathological portraiture or ‘pathography’ (2), and quoted the French poet Paul Verlaine to show ‘the loathsome condition of his mind’ (3). Nordau also quoted the Symbolist poet René Ghil in the original French, but deliberately did not provide a German translation (5). Doctors used this linguistic technique to morally preserve the reader and maintain a distance between the clinical fact and its narrative, and it also preserved the writer whose pen ‘remained chaste’ (5–6). Nordau’s work, dedicated to Lombroso, applied scientific thinking to the arts, concluding that literary modernists such as Naturalists and Decadents were a danger to society as their texts displayed a ‘pathological character’ (Nordau, [1892] 1993: Introduction, vi). Between 1890 and 1900, Entartung was one of Europe’s ten bestselling books (Söder, 1991: 474), so the crossover of medical theory and literature was in mainstream fin-de-siècle European culture.

The concept of degeneration (mental, moral, and physical decline) was a transnational phenomenon and, for Nordau, France was the most degenerate of countries (Otis, 1994: 53).6 The state of degeneration was ideological, and works on it were often written by doctors, anthropologists, and zoologists, so they had the appearance of being scientific truth (Pick, 1989: 20). First put forward in 1857 by the French psychiatrist Bénédict Morel in Traité des dégénérescences physiques, intellectuelles et morales de l’espèce humaine et causes qui produisent ces variétés maladives, degeneration was thought to be caused by poor housing and inadequate working conditions, which would lead to vices such as alcoholism and prostitution. These living conditions would produce corrupted individuals, and their families would continue to degenerate in later generations through heredity (Cleminson and Fuentes Peris, 2009: 386). The phenomenon of degeneration rose to prominence in different European countries in the late 19th and early 20th centuries, and was diagnosed by the emerging sciences of criminology, psychiatry, and the sexual sciences. This was known collectively in the Hispanic world as ‘la mala vida’, and manifested differently between countries: France was concerned about revolution, but Italy had issues from post-unification (385). Spain’s calls for the regeneracionismo of the nation was entwined with ideas of degeneration (Álvaro Girón Sierra, as quoted by Cleminson and Peris, 2009: 385). The concept of ‘la mala vida’ became a transnational phenomenon, with many authors translating texts or making contributions to other texts on the subject (385).7

IV: Rewriting Narratives

As Donna Haraway observes, ‘biology is discourse’ (as quoted by Shildrick, 2002: 10). As discourse requires a narrative, literature can provide a space to combat medical models by rewriting them. In 19th-century France, the battle had to be first fought on a basic linguistic level as the Grand dictionnaire universel du XIXe siècle, in its definition of ‘homme’ [man], makes the masculine the primary term (Nigel Harkness, as quoted by Rickard, 2021: 8), and the feminine becomes subordinate (8). Medical theories defined ‘man’, and language and culture supported this naturalisation. The novel was one of the 19th-century’s ‘plots of containment’ for the ‘deviant’ female body (Jann Matlock, as quoted by Wilson, 2020: 3), but it was also a space where non-normative and marginalised authors could take control of their narrative. The literary sphere served as battleground. In the field of gender studies, Judith Butler advocates for a ‘radical resignification’ of the symbolic domain in order to expand the meaning of what is counted as a valued body (1993: 21–22). With the aim of reversing 19th-century medicine’s naturalisation of bodies, which would be an undoing of the medical template, I wish to reiterate the value of Butler’s insight of language as a tool that has the potential to create change. Although Butler is writing specifically about gender, the concept can be used to work through the patriarchal bias that has simultaneously created categories of race and class. As Butler observes, nature has a history (5), and that history must be recognised to be manufactured and often a violent imposition. If there is no such thing as a split between the organic and the symbolic, as French philosopher Catherine Malabou contends (Dalton, 2019: 241), the linguistic has a crucial role in refashioning medically embedded ideas of the body in untethering the patriarchal control on material bodies (and lives). Writing on feminism, Sara Ahmed notes that patriarchal reasoning ‘goes all the way down, to the letter, to the bone’, and this encapsulates the link between language, literature, and the living body (2017: 4).

Butler argues that we are called into subjectivity via language (as quoted by McCann, 2016: 230). Relatedly, as an act of self-realisation, the French feminist Hélène Cixous writes that ‘Woman must write her self … put herself into the text—as into the world and into history’ (1976: 875). Simone de Beauvoir critiques Cixous’s wish to write in a women’s language as it would restrict the dissemination of what would be of interest to many women (Jardine, 1979: 229); it would be better to ‘steal the instrument’ and wield it with a feminist sensibility, but it would, nonetheless, be ‘the language … a universal instrument [which is not an] artificial language’ (230). Julia Kristeva, Luce Irigaray, and Monique Wittig have also written about écriture féminine, whereby to write from the body is to recreate the world (Jones, 1981: 251–52), but they have been criticised for treating the female body as essentialist (252–53).

The need for nuance in conveying human identity is crucial to prevent subjective distress. The French writer Rachilde challenged 19th-century gender hierarchies, and Rachel Mesch suggests that it is better to view the novelist through a trans framework than a feminist one as Rachilde rejected the category of woman, sometimes insisting they were a man and other times a werewolf (Mesch, 2021: 242). The trans lens, moreover, privileges self-knowledge over other forms, so that trans people become ‘active participants in the construction and contestation of medical discourse’ (Jules Gill-Peterson, as quoted by Mesch: 2021, 246). Rachilde’s denial of the binary registered linguistically in the character Raoule, in Monsieur Vénus (1884), who used both masculine and feminine personal pronouns (245).

Nineteenth-century Spanish novelists were also rewriting the medical narrative. Los pazos de Ulloa (1886) by Pardo Bazán contains one of the earliest representations in Spanish literature of a woman with the symptoms of hysteria (Ragan, 2004: 141). Bazán’s novel rejects medical theories that blamed the woman for the condition, and suggests instead that hysteria is created by women’s social positioning (146). Indeed, the woman who fulfils the ‘ángel del hogar’ [angel in the house] role that 19th-century medicine recommended to women is punished or dead by the end of the story in much of Bazán’s work (Gabriela Pozzi, as quoted by Ragan, 2004: 146).

Up to and in the 19th century, writing was historically considered a masculine activity but non-normative masculine Decadents in the French fin de siècle exploited this link to subvert and redefine masculinity textually (Rickard, 2021: 1, 2). Decadent authors enthusiastically undermined social and gender norms, and the newness of their texts was equated with the new approaches to challenging the perceived natural order of normativity. In his review of Joris-Karl Huysmans’s 1884 novel À Rebours [Against Nature], Jules Barbey d’Aurevilly describes the decline of Europe in racial terms by seeing the novel as proof that ‘we are … a race in its final hour’, which invokes degeneration theory as biological decline (Hartley, Suwanwattana and Yee, 2022: Introduction, 9).8 Moving beyond the all-male Decadents, Melanie Hawthorne identifies an extensive international movement of women Decadent writers, a ‘lost generation’ from Norway, Finland, Spain, Russia, Poland, and France (2019: 1–2). The project of self-determination becomes more complex when taking into account Eastern Europe, as the language of Ukrainian Decadent authors was effectively banned by the Russian Empire until 1905 (Dovzhyk, 2022: 229).

The literary form is a tool for actively shaping identity. Queer and trans life writers in the early 20th century in Germany wrote with and against sexual-scientific knowledge to create a sense of sexual subjectivity through ‘textual strategies’ (Linge, 2023: 3). Contemporary theorists have brought together the realms of biology and society in the ‘bio-social’, the ‘biocultural’, and the ‘bio-humanities’ (Gill, 2020: 20). Josie Gill and others are engaged in showing how the literary, alongside the social and the cultural, is involved in the production of a biomedical imaginary (126). For Gill, fiction is an active agent in the making of race in scientific contexts (24); culture can become embodied, and epigenetics reveals how the experience of being racialised influences genetic development and inheritance (123). In a lecture on race, Stuart Hall spoke of science having a cultural function in society that provides a guarantee of absolute difference that no other system of knowledge has been able to provide (1997: 12). What matters is not that there is a scientific truth of difference, but that it fixes the discourse of racial difference (13). Hall invokes the power of narrative when he notes that the power of Fanon’s Peau noire, masques blancs lays beneath the corporeal schema, and it is this lower layer—composed of stories, anecdotes, metaphors, images—that constructs the relationship between the body and its socio-cultural space (16).

Modern Languages: Power in Collaboration

The six articles in this Special Collection tackle the multivalent nature of the concept ‘pathological body’. Showing the link between language(s), the literary, and the biological, the essays explore the political, social, cultural, and historical forces that coalesce around the term. Covering four language disciplines and focusing on literary texts from the 19th century to the contemporary, the articles show that the influence of medical theories formulated over 150 years ago on the human subject are still prevalent and have the power to determine subjectivity and identity.

The female body as site of fantasy and anxiety is the subject of Françoise Campbell’s article (2021), which focuses on the French writer Marie Darrieussecq’s novel Notre vie dans les forêts (2017). A science fiction dystopia, the topics that it raises are central to how societies see women, leading them to have a distorted self-image. Drawing on posthuman theory, the essay probes the novel’s exploration of how the quest for physical perfection harms a person’s subjectivity. In tracing the gradual breaking down and estrangement of the female protagonist’s psychological state in consonant with the linguistic and narrative fragmentation of the text itself, the essay highlights the vital question of what can be considered ‘natural’ and human if bioengineering goes to extreme lengths to perfect the human.9

The patriarchal limitations on women authors are discussed in James Illingworth’s article (2022) on the two Consuelo novels (1842–44) of the 19th-century French novelist George Sand. The medical condition of catalepsy, a form of living death where the muscles become rigid and stop responding to external stimuli, becomes the focus through which Sand is able to reorient the gender narratives that impede women socially and creatively. Illingworth demonstrates how, in Sand’s hands, catalepsy becomes an inclusive, generative framework through which her protagonists undo traditional narrative endings that replicate traditional models of masculine domination, while producing a more empathetic knowledge than is procured through the medical gaze. Sand’s approach is in contrast to that of contemporaneous male writers, who show the cataleptic as an unstable male genius whose narrative ends in death or madness. Thus Sand contravenes the long historical belief that genius was biological and reserved for men only. Sand’s work is political and is a call for new beginnings that goes against the prevailing social discourse.

The violence involved in maintaining a socially acceptable subjecthood is the theme of Robert Craig’s article (2022) on the two German modernist doctor-writers Alfred Döblin and Gottfried Benn. German Expressionism takes the experience of alienation as an effect of the literary text, which the reader also experiences, and it is this feature that Craig puts in critical dialogue with Rita Charon’s concept of narrative medicine (Murphy, 1999: 17–18). Charon theorises that it is through narrative, in the patient’s telling of their own medical story to a listening clinician, that a more thorough diagnosis may be arrived at than could be done through purely ‘clinical’ knowledge. Yet, as Craig notes, this would not be possible for patients who are not able to articulate their own narrative in this way. The article examines representations of mental illness in Döblin’s short story ‘Die Ermordung einer Butterblume’ (1912), and Benn’s cycle of ‘Rönne novellas’ (1916), and traces the futile attempt of each protagonist to control their chaotic body-mind. No amount of willpower can resolve the disjointed connection between their body and mind, but this in itself holds the possibility for the potential acceptance of non-normative states. The Expressionist texts show a brokenness within these protagonists at close range, but Craig’s attentive reading reveals the persistent humanity of these figures who are struggling with the pressures of modern masculinity. The essay reiterates that the psychological line between ‘normal’ and ‘abnormal’ is tenuous, and that mental illness as a combination of psychosomatic, social, and physiological factors is complex. The essay shows, finally, that difficult, non-linear narratives that trace apparently unreadable and fragmentary subjectivities, such as modernist ones, are vitally useful in beginning to understand the human subject via a new picture of subjecthood.

The question of what a body is forms the core of my own contribution to this Special Collection (Wong, 2021b), focusing on the 19th-century French writer Émile Zola’s depiction of the vacillating Catholic priest in the novel La Faute de l’abbé Mouret (1875). Through Mouret’s illness, the human body is shown to be captured within the intricate web of nation, competing religious and secular discourses, and language itself. Through Zola’s Naturalistic framing, illness becomes the epistemology through which there is the possibility of forging a new self; in Mouret’s case, he oscillates between a religious and a secular self. What becomes clear is how much the body’s materiality is enmeshed with contemporaneous national political discourses, so the religious symbols of the heart and blood are fought over alike by the Church and Republic. This happens on a physiological level and also through language as, by dismantling the linguistic framework of religious myth, Mouret’s religious identity and his very self can also be dismantled at the start of a fledgling secular French republic that wishes to leave religion behind. For Zola, illness is world-building, and his brand of Naturalism reveals the fragile self beneath the discourses that subsume bodies and identities.

Moving from Naturalism in the French context to a Spanish one, the migration of 19th-century influences across European national borders—literary, medical, and social science—is evident in Katharine Murphy’s article (2022) on Vicente Blasco Ibáñez’s novel La barraca (1898). The essay discusses the symbiotic relationship between the bodies of the peasants in a small community in Valencia and that of the surrounding land itself, extending the dominant critical emphasis on the Naturalist foundation of Blasco Ibáñez’s Valencian novels. Blasco Ibáñez admired French Naturalism, and this inspiration consequently figures the ‘pathological’ in his novel as a trope of infection that is at once physiological, emotional, social, and environmental. The figurative and the literal conjoin to show the sickness that is created from the harsh life that is endured by the rural working class. The essay dissects the novel’s use of the prominent 19th-century concepts of crowd theory and degeneration, which described contemporaneous social groups such as women, children, and the working class as irrational, uncivilised, dangerous, and even primitive. Emotional contagion, channelled from person to person as well as through the physical environment, triggers the group violence that is perpetrated in the novel. This uncovers both the corruption of a peasantry who have been brutalised by the effect of poverty and also that of the bourgeoisie who create oppressive conditions for the peasant class. The ‘pathological’ in this essay shows the corrosive physical and mental effects of living in a society that is fundamentally inequitable.

Contagion also features in Marta Arnaldi’s essay (2022), but in this case it is a force for wellbeing as it connects translation, language, and epidemiology in a ‘translational paradigm’. More than being a mere transfer of words and meanings from one language to another, Arnaldi posits translation as an epistemic category upon which health depends. Correspondingly, the literary, through its meaningful connection with language, is as pertinent a tool as biochemical interventions when faced with an epidemic health crisis. Testing this theory in five Italian and Francophone novels—Alessandro Manzoni, I promessi sposi (1842); Albert Camus, La Peste (1947); J-M G Le Clézio, La Quarantaine (1995); Nicola Gardini, La vita non vissuta (2015); Véronique Tadjo, En compagnie des hommes (2017)—the article traces the linguistic dimensions of epidemics, where translation is formulated as a type of non-fatal contagion that allows the reader to benefit from the positive effects of life-bearing words and relations. By putting textual analysis, translation studies, and philosophy into dynamic exchange with epidemiology and immunology, Arnaldi advocates for the application of humanities methods and resources to the understanding of diseases, plus the inclusion of scientific approaches to the study of literature.

The articles together show how the human body is fundamentally enmeshed within socio-cultural concerns, and it is clear that there is further scope for more collaborative research across language disciplines. Literary critical medical humanities recognises the humanness of subjects that is often erased by medicine and questions fundamentally flawed concepts such as the ‘normal’ and ‘natural’, which are biased towards the Western European masculine imagination. The task is more than one of comparing language(s), but of mining them and of close reading the linguistic expression in fiction, poetry, and other genres in all periods that show a society’s view on gender, race, and other minoritised statuses. By thinking trans-linguistically, how much more could we find out about medicine’s reach and the struggle to rewrite the narrative against its entrenched definition of the human?10


  1. Other recent French Studies publications on the body include: an overview of works in the last 20 years on the 19th-century body (Harrow, 2021: 187–95); works on emotion in the 19th century (Harrow, 2023: 2–18); a special issue arguing for a critical French medical humanities (McCaffrey and Larkin, 2021); a special issue on transnational and interdisciplinary approaches to disease for a global medical humanities (Grayson and Wilson, 2023); a special issue on what French cultural production can contribute on the experience of death (McCaffrey and Wilson, 2021); and, contributing to the growing sub-field of translational medical humanities, the importance of going beyond the Anglophone in future pandemics (Blumczynski and Wilson, 2023).
  2. ‘… les trois A’.
  3. ‘… il y a une véritable tâche à accomplir pour devenir un homme. La virilité n’est pas donnée d’emblée, elle doit être construite, disons “fabriquée”’. / ‘… there is a veritable task to undertake in becoming a man. Virility isn’t a given from the outset, it must be constructed, let’s say “made”’. All translations are mine unless otherwise stated.
  4. Sex and gender were integral to 19th-century society and culture: in the context of heightened nationalism, German doctors and psychiatrists developed guidelines to treat individuals whose sex-gender characteristics did not conform to dominant norms (see Sutton, 2023: 52); the explosion of representations of intersex coincided with the vertiginous literary rise of ‘hermaphrodism’ in France (see Linton, 2022).
  5. See Duffy, 2015, on the relation between scientific discourse, text, and the body in Flaubert’s and Zola’s novels.
  6. I have written elsewhere on reading Zola’s 1892 novel La Débâcle through the lens of Nordau’s degeneration, which shows the physiological body as the site of morality (see Wong, 2021a).
  7. Echoing the 19th century, see Wampole, 2020, on the 21st-century strand of French literary realism that is biopolitical and relies heavily on the metaphor of biological degradation to suggest cultural and social entropy.
  8. ‘… nous sommes … une race à sa dernière heure’.
  9. See Carlini Versini’s 2020 special issue on Darrieussecq; the Introduction outlines the special place of science and its language in Darrieussecq’s novels, which present the human body as being in liquid, solid, or gaseous states (6).
  10. This Special Collection came from my symposium ‘The Pathological Body from the Mid-Nineteenth Century to the Present: European Literary and Cultural Perspectives’, which took place at the then Institute of Modern Languages Research (now the Institute of Languages, Cultures and Societies) in London, UK, on 20 September 2019. Details may be found on the project website, including video recordings of seven of the papers (Wong, 2019). I wish to acknowledge the ILCS’s Cassal Endowment Fund and the UK Society for French Studies for their generous funding for the conference, plus I am grateful for the contributions of Amanda Sciampacone, Philippa Lewis, and Damian Catani for chairing panels, the keynote speaker Steven Wilson, and the speakers.


I am immensely grateful for the hard work and collaboration of the article contributors and the productive critique of the peer reviewers; it has been a real pleasure to experience four language disciplines working together. Many thanks, also, to the dedicated team at the Open Library of Humanities—Rose Harris-Birtill and Simon Everett—for taking the Collection through so smoothly. The project was made possible by my associate research fellowship at Birkbeck, University of London, UK.

Competing Interests

The author of this introduction is the editor of the Special Collection.


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