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Literature and Medicine, Volume 31, Number 1, Spring 2013, pp. 17-39
(Article)
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DOI: 10.1353/lm.2013.0005

For additional information about this article

http://muse.jhu.edu/journals/lm/summary/v031/31.1.gallagher.html

Accessed 26 Aug 2015 18:26 GMT

Noelle Gallagher

17

Satire as Medicine in the

Restoration and Early
Eighteenth Century: The
History of a Metaphor
Noelle Gallagher

The true end of Satyre, is the amendment of Vices by correction.

And he who writes Honestly, is no more an Enemy to the Offendour, than the Physician to the Patient, when he prescribes harsh
Remedies to an inveterate Disease.
John Dryden, Preface to Absalom and Achitophel
When Dryden chose to defend his political poem as the harsh
Remedy prescribed by a well-meaning physician, he was drawing on
a figurative conception of satire that would already have been familiar
to readers in 1681.1 The medical model of satire, as Mary Claire
Randolph has termed it, was central to Renaissance satiric theory,
and comparisons between satirists and physicians, satire and medicine, appeared in a wide range of early modern texts.2 According to
Randolph, the medical model reached its apex in the fifteenth and
sixteenth centuries and was then replaced by an intellectual nomenclature that became current and fashionable as the earlier medical
vocabulary had been current and fashionable.3 As my epigraph from
Dryden suggests, however, comparisons between satire and medicine
would continue to hold an important position within critical accounts of
the genre throughout the Restoration and on into the early eighteenth
century. Indeed, medical rhetoric not only remained important in the
theorization and classification of satire, it also played a prominent role
within satiric literature, as satirists began to complicate, and in some
cases challenge, the conventional critical associations between satire
and medicine.
Literature and Medicine 31, no. 1 (Spring 2013) 1739
2013 by The Johns Hopkins University Press

18

The History of a Metaphor

Some of the poets and prose writers working between 1660 and
1760Tobias Smollett, Oliver Goldsmith, John Arbuthnot, Samuel Garth,
Richard Blackmore, Mark Akensidemight have had a personal incentive to correlate medical and satiric practices, because they themselves
had been trained as physicians or surgeons. Yet many writers not
actively involved in the practice of medicine also sought to explore
the changing relations between medicine and literatureand especially
between medicine and satire. Some such explorations were acts of
tribute (Popes 1735 Epistle to Arbuthnot is one notable example); but
the eighteenth century also saw the production of an extraordinary
array of satiric attacks on mercenary, ignorant, or pretentious medical
practitioners. From the pompous Latinity of Fieldings surgeon in Joseph
Andrews (1742) to the farcical forceps work of Sternes Doctor Slop in
Tristram Shandy (1759), the practices of professional medicine remained
a favored target among eighteenth-century satirists. For writers like
Sterne and Fielding, the satire-as-medicine commonplace was not just
a means of prescribing harsh Remedies to an inveterate Disease: it
was also a means of exploring wider cultural concerns that affected
the practices of both medicine and satire.
This essay will survey some of the uses and implications of the
satire-as-medicine commonplace in British literature between 1660 and
1760. In examining several of the similaritiesand differencesbetween
satiric and medical theory, I want to suggest that Restoration and earlyeighteenth-century satirists defined their genre strategically, identifying
satire as a therapeutic practice sometimes in alignment with, and
sometimes in opposition to, the work of contemporary medical practitioners. Ultimately, I suggest that Restoration and eighteenth-century
satirists used the satire-as-medicine commonplace not only to defend
potentially offensive or libellous statements, but alsoand perhaps
more importantlyto engage with a number of debates relevant to
both literary and medical practice, including the clash between the
ancients and the moderns, the divisions between the arts and the
sciences, and the shift from a patronage-based system of production
to a commercialized marketplace.
Healthy Body, Healthy Mind: Disease and Morality 16601760
The comparison between satire and medicine was only one of
several commonplaces by which Restoration and eighteenth-century
critics defined satiric literature.4 The medical model had maintained

Noelle Gallagher

19

a particular prevalence and resilience over the centuries, however, in

part because it tied in with a broader understanding of human experiencean understanding that made strong connections between physical
and mental states of being, and particularly between moral virtue and
physical health. As Roy and Dorothy Porter have demonstrated, the early
modern approach to health was what we might now term holistic.5
Illness was understood as a problem that affected the whole person,
and specific ailments were often traced back to personal problems in
the character or habits of the individual patient.6 Popular and professional wisdom continued to emphasize the role of the constitution
in determining and reflecting health, and visible symptoms of illness
could be identified as markers of inherent problems or flaws in the
patients own character. Equally important were the non-naturals, six
extrinsic factors that, while essential to human life, could also prove
harmful or disease-causing if improperly regulated. Physical ailments
might be attributed not only to inherent constitutional tendencies, then,
but also to excesses, insufficiencies, or impurities in diet, excretions,
air, exercise, sleep, and the passionsfactors in what we might now
describe as a patients lifestyle.7
While the range of medical theories circulating in this period
was very broad, the links between patient health, behavior, and disposition encouraged many medical practitioners to identify physical
ailments with moral failings, and vice versa.8 Even if a mans constitution predisposed him to a certain illness, he could still attempt to
follow a regimen that balanced out these intrinsic tendenciesand
certainly he could refrain from indulging in behaviors that exacerbated
or brought on physiological problems.9 While environmental factors
like boggy air werent always within a patients control, many of the
other non-naturals were associated with behaviors that carried clear
moral resonances: eating too much (gluttony) was a sin, for example,
as was too little exercise or too much sleep (sloth). Similarly, the category of the passions would have invited the association of sinful
emotions like wrath, envy, or lust with physical illness. In prescribing
a medication or recommending changes to a patients lifestyle, then,
a physician might well have been identified as treating the mind or
the morals as well as the body.
It was this sense of medicines ethical purposesor, more broadly,
of the link between moral and physical healththat provided perhaps
the strongest rhetorical underpinning for a parallel with satire. From
the classical period onward, satire had been characterized by poets
and critics as a genre that pursued an elevated moral purpose. As

20

The History of a Metaphor

the physician-turned-poet Richard Blackmore put it in 1695, Satyr

is intended for . . . the Promotion of Virtue, and exposing of Vice;
which it pursues by sharp Reproaches, vehement and bitter Invectives,
or by a Courtly, but not less cutting Raillery.10 Similarly, Nahum Tate
explained that The Representing of Vertue and Vice in their respective Beauties and Deformities, is the genuine Task of Poetry: the true
and proper themes of Panegyrick and Satyr.11 And in 1697, Drydens
influential Discourse of Satire identified a moral mandate as the genres
defining feature: that which is most Essential to this Poem, and is
as it were the very Soul which animates it, is the scourging of Vice,
and Exhortation to Virtue.12
As Drydens reference to scourging perhaps suggests, many
writers of Restoration and early-eighteenth-century satires described their
moral aims in physical terms. More to the point, for many satirists, the
link between spiritual and bodily health meant that satires remit was
not just moral, but medical. Accordingly, throughout the early modern
period, satire was presented as a kind of medicine for the mind or
soul, designed to treat moral corruption in much the same way that a
course of physic could treat bodily illness. The poet Thomas DUrfey,
for example, contended that Satyres, just like Medicines, are designd,
/ As those the body cure, so these the mind.13 Thomas Emes, evoking the same comparison, suggested that satire could be prescribd
against some Maladies endangering the Life and Health of Men, that
have their root in the Mind; such as Pride, Ignorance, Confidence,
Covetousness, &c.14 And throughout the period, satiric works appeared
with titles or subtitles that indicated their role in treating various
social or individual ills: A Pill to Purge State-Melancholy, A Cure
for a Scold, A Remedy for the Gout.15
As a function of this association between physiological and moral
health, satirists were often compared with medical practitioners, or
identified as diagnosing or curing societys vices. Drydens famous
distinction in the Discourse between Horatian and Juvenalian satire was
articulated, among other ways, as a contrast between physic and surgery, with Horace characterized as a general practitioner treating minor
ailments, and Juvenal cast as a barber-surgeon enjoined to perform an
amputation.16 The treatment performed by Juvenal, Dryden explained,
was an Ense rescindendum; but that of Horace was a Pleasant Cure,
with all the Limbs preservd entire: And as our Mountebanks tell us in
their Bills, without keeping the Patient within Doors for a Day. What
they promise only, Horace has effectually Performd: Yet . . . Juvenals
Times requird a more painful kind of Operation.17 Each satirist could

Noelle Gallagher

21

possess his own area of expertise, Dryden suggested, making satirists

much like the increasing number of medical practitioners known for
treating a specific problemspecialists whose skills were of use or
importance according to the health and character of their Times.18
In addition to the tropes of satirist-as-physician and satire as
medicine for the mind, the association between medical and satiric
practices could also be figured in a number of other ways. In some
texts, satires offered less a cure than a prescription; they specified a
treatment that it was ultimately up to the patient-reader himself to
implement. Dryden echoed his French source, Andr Dacier, for example,
when, later in the Discourse, he compared satiric literature to a book
of home remedies: They who endeavour not to correct themselves,
according to so exact a Model; are just like the Patients, who have
open before them a Book of Admirable Receipts, for their Diseases,
and please themselves with reading it, without Comprehending the
Nature of the Remedies; or how to apply them to their Cure.19 Where
the comparison between Horace-as-physician and Juvenal-as-surgeon
accorded primary agency to the satirist, here Drydens account suggested that satires merely provided curative recipes; it remained up
to the reader to pursue treatment.
Equally, the poet and courtier Sir Carr Scroope remarked that
satire offered wholesome Remedies for those oppressed by Sickness of Mindbut its prescriptions could also be helpful cautions,
he argued, for those in danger of succumbing to moral ills:
For, as the Passing-Bell frights from his meat
The greedy sick Man, that too much would eat;
So, when a Vice ridiculous is made,
Our Neighbours Shame keeps us from growing bad.20
By applying to himself the satiric Remedies issued to another sick
Man, a self-aware reader, Scroopes lines suggested, could even use
satire as a kind of preventive medicine.
Cure and Punishment
While different writers figured the satire-as-medicine trope in
different ways, most were united in conceiving of satire not just as
curative, but as punitive. In this preference for unpleasant medicine,
too, the work of the satirist mirrored that of the medical practitioner.

22

The History of a Metaphor

Treatments for illness in the seventeenth and eighteenth centuries

were almost exclusively based on practices of removal or extractionand, perhaps needless to say, such practices tended to be very
unpleasant. Nicholas Jewson has suggested that physicians favored
more intensive treatments because these satisfied aristocratic patients
with the sense that they were getting their moneys worth21but
the particular emphasis on bleeding and other forms of purgation
did have a logical basis within the Galenic model of medicine: if illnesses were the result of imbalances in the humors, then it stood to
reason that removing some amount of bodily matter or fluid would
remove a proportionately larger amount of the excessive humor than
of the other humors.22 Even when humoral theory began to fall out
of favor, medical theorists still identified corrupted matter as the
primary cause of illness, and recommended removal of the offending
substance as the best course of treatment.23
Accordingly, in addition to the popular methods of drawing
bloodby slitting open a vein, cupping, or, less frequently, by the use
of leechesseventeenth- and eighteenth-century medical practitioners
administered vomits, purges, and clysters. If bleeding, vomiting,
urinating, or defecating couldnt effect a cure, patients might endure
the removal of other bodily fluids: the mercury treatments commonly
prescribed for syphilitics, for example, resulted in a massive overproduction of saliva, as well as a sweat-soaked fever. Its not difficult to see
how these sorts of treatments might be conceived of as penitential: just
as a disease could be understood as the result of some intemperance
on the part of the patient, so the treatment might be viewed as the
correctiveor the proportionate punishmentto the original failing.
Satirists, in keeping with early modern medical practices, also
often viewed themselves as attempting to treat the distemperd Mind
. . . by bitter and unsavoury but salutary Applications.24 Within seventeenth- and early-eighteenth-century satiric theory, figurations of satire
as physically punitive were often combined with, or subordinated to,
conceptions of the genre as curative or therapeutic. Equally, praises
directed toward the satirist as a physician could be presented alongside fearful warnings of his violence or ruthlessness. Satire was often
represented as a lash to vicesindeed, by the time Samuel Johnsons
Dictionary appeared in 1755, the verb to lash had to scourge with
satire listed as its fourth meaning25and the skilled satirist, scourge
in hand, could not only whip his victims, but also bite, sting, or even
kill them.26 According to Drydens Discourse, the highest attainment of
satiric skill lay in learning to deliver such punitive violence sweetly

Noelle Gallagher

23

and expertly: there is still a vast difference betwixt the slovenly

Butchering of a Man, and the fineness of a stroak that separates the
Head from the Body, and leaves it standing in its place. A man may
be capable, as [the famed executioner] Jack Ketchs Wife said of his
Servant, of a plain piece of Work, a bare Hanging; but to make a
Malefactor die sweetly, was only belonging to her Husband.27 Like
his description of Juvenalian amputation, Drydens account of satiric
decapitation validated the exercise of violence for the greater health of
the social body. Executed on the offending members of society, satiric
assassination wasnt violence; it was surgery.
Although Drydens account pushed the logic of punitive satire
to a disturbingly homicidal extreme, critics routinely connected the
violence of satire with its role in treating moral ills. Satire could
scourge and mend a venal age;28 it could purge the nation of
state disorders;29 it inflicted wounds that could cure.30 As these
descriptions suggest, the treatments offered by satiremuch like those
favored in medicinewere strongly focused on the removal of undesirable elements: the satirist could lance boils or amputate limbs, dispense
emetics or laxatives, draw blood, or burn off the affected area with his
caustic humor.31 The poet Edward Young offered a particularly witty
articulation of the satirists urge to purge (and perhaps made a sly
allusion to Popes real-life dosing of the bookseller Edmund Curll with
an emetic in 1716)32 in his Conjectures on Original Composition (1759):
But as good books are the medicine of the mind, if we should
dethrone these authors, and consider them, not in their royal, but
their medicinal capacity, might it not then be said, that Addison
prescribed a wholesome and pleasant regimen, which was universally relished, and did much good; that Pope preferred a purgative
of satire, which, tho wholesome, was too painful in its operation;
and that Swift insisted on a large dose of ipecacuanha, which,
tho readily swallowed from the fame of the physician, yet, if the
patient had any delicacy of taste, he threw up the remedy, instead
of the disease?33
Here Youngs account expanded the satirist-as-physician trope to
consider the medicinal capacity of literature across the genres, contrasting the purgative treatment of satire against the wholesome
and pleasant regimen suggested by forms like the periodical essay.
While an individual satirist might vary in the extremity of the treatmentwith Pope delivering a painful laxative and Swift a toxic dose

24

The History of a Metaphor

of emeticthe nature of the remedy as evacuative or purgative

remained the same.
Further, as Youngs remarks on Swift suggest, the violence of a
satiric cure could be such as to produce an affliction as severe as the
disease it ostensibly sought to treat. In early modern popular perception, as we have seen, ailments were often understood as punishment
for misbehavior of some sortbut medical treatment could also bear a
punitive aspect. Similarly, within satiric theory, satire was paradoxically
figured as both a punishing remedy for social vice, and an affliction
with disease-like virulency.34 Thus the term scourge, although commonly applied to satire, was also used to describe epidemic diseases,
for example.35 In the same way that the satirist could bite or lash
his victims, so he could plague them with his criticisms. Reconfigured in this way, satire might be understood not as the work of a
physician or a surgeon, but as the spleen or gall of an infected
patient, whose ill feelings could only be soothed by purging them
onto the page.36
Satirist as Physician and Physician as Satirized
As a defensive strategy, the satire-as-medicine commonplace
enabled a writer to declare his ostensibly altruistic motives, drawing a flattering comparison between his own purposes or methods
and those of a contemporary medical practitioner. But just as the
satirists noblest aims could be captured in his role as societys physician, so his failings could be upbraided, in a reformulation of the
same metaphor, as the work of a quack or mountebankand satirists
working throughout the long eighteenth century sought to attack their
political or literary rivals in exactly these terms.37 In A Supplement to
One Thousand Seven Hundred Thirty-Eight (1738), for example, Thomas
Newcomb lamented the increasing number of literary quacks to good
physicians, complaining that Arts pine, quacks flourishR-ck and
M-rg-n kill.38 Linking the commercial corruption of the medical and
the literary spheres, Newcomb identified writers-for-hire like Nicholas
Amhurst with quack doctors like Richard Rock and Thomas Morgan,
and opposed all such exemplars of bad practice to Alexander Pope,
the scourge and cure of every vice.39 Newcombs subsequent poem,
Danvers and Moore; Or, the Rival Quacks (1740), similarly ridiculed
Amhurst (who wrote under the pseudonym Caleb DAnvers) by comparing his anti-Walpole newspaper The Craftsman with the quackery
of the apothecary John Moore.40

Noelle Gallagher

25

Predictably, those who practiced at both physic and literature

proved to be particularly popular targets for the accusation of quackery. Charles Sedley, Samuel Garth, and Tom Brown were among the
many satirists who mocked Richard Blackmore, for instance, as both
a hack writer and a quack physician. According to Sedley, the author
of the Satire Against Wit (1700) was like a Quack in pedaling such
ineffectual satiric cures:
It is a common Pastime to write ill;
And, Doctor, with the rest, een take thy fill.
Thy Satyrs harmless; tis thy Prose that kills.
When thou prescribst thy Potions and thy Pills.41
Sedleys lines portrayed Blackmore as an inversion of the satirist-asphysician ideal: a literary and medical mountebank whose harmless
insults contrasted against his deadly prescriptions. Garths mock-epic The
Dispensary (1699) attacked Blackmore on similar grounds, caricaturing
him as the pretentious apothecary-turned-Bard whose invocations
like his medicines, presumablyfailed to produce the desired effect.
As these attacks suggest, both satire and medicine depended to
some extent on the practitioners public persona, with prestige hinging
on the satirists or physicians ability to project an air of intellectual
authority. Practitioners within both fields accordingly sought not only
to display their own abilities, but also to position themselves against
an imagined underclass of hack or quack performers. While the
contrast between good and bad medicine, high and low art,
was sometimes played out quite straightforwardly (as in the epic battle
of the Dispensary), the tensions between satirist and hack, physician
and quack, could also be figured more obliquely. The persona of the
mountebank offered irresistible opportunities for satiric play, and some
of the best-known writers of the period ironically impersonated or commended quacks in order to enhance their own satiric performances.42
The slippery narrator of Swifts preface to A Tale of a Tub (1704), for
example, aligned himself with a quack by identifying the ladder, the
pulpit, and the stage itinerant as the three wooden machines used
to project the voices of criminals, Covenanters (Scottish Presbyterians),
and mountebanksall of whom, he explained, were orators who
desire to talk much without interruption.43 Situating his own work
and that of other Grub Street hacks within this oratorical tradition,
Swifts narrator explained that such texts were properly classified as
belonging specifically to the stage itinerant, along with mountebanks
performances:

26

The History of a Metaphor

Under the Stage-Itinerant are couched those Productions designed for

the Pleasure and Delight of Mortal Man; such as, Six-peny-worth of
Wit, Westminster Drolleries, Delightful Tales, Compleat Jesters, and the
like; by which the Writers of and for Grub-Street, have in these latter
Ages so nobly triumphd over Time. . . . It is under this Classis,
I have presumed to list my present Treatise, being just come from
having the Honor conferred upon me, to be adopted a member of
that Illustrious Fraternity.44
By identifying the Grub Street fraternity with the stage itinerant,
Swifts narrator suggested that hack writers shared the same mercenary
purposes and sensational performing style as the mountebanks whose
fly-by-night work required a movable stage.45 At the same time, Swift
gave his own satiric performance, impersonating a literary mountebank in order to parody the moral and aesthetic failings identified
with hack writing.46
Similarly, in the Narrative of Dr. Robert Norris (1713), Pope used
the persona of the quack doctor as a means of ridiculing the hotheaded literary critic John Dennis.47 Presented as the testimony of a
discredited physician, the Narrative defended Dr. Norriss actions in his
encounter with one Mr. John Denna patient whom he had been
summoned to examine, and in the treatment of whose exceeding
hot temperament he had been obliged to make use of Force.48 As
a result of the ensuing altercation, Norris explained, the furious Dennis
had spread rumors that I enterd into his Room . . . either out of a
Design to deprive him of his Life, or of a new Play called Coriolanus,
that I was an Accomplice with his Bookseller, who visited him with
Intent to take away divers valuable Manuscripts, without paying him
Copy-Money, and that I am no Graduate Physician, and that he had
seen me upon a Mountebank Stage in Moorfields.49 Much like Swifts
Tale, Popes text aligned the voice of the hack writer with that of
the mountebank, linking the charges of quackery and plagiarism. By
adopting the voice of the shady Dr. Norris, Pope was able to parody
both medical and literary malpractice, exposing the mountebanks authority as a pose while also taking aim at a literary opponent. If the
principal purpose of literary criticism was, in Popes view, diagnostic,
then the Narrative offered a fantasy of reversal, empowering the artist
to diagnose as mental illness the fury of his severest critic.
Perhaps the most flamboyant mountebank impersonation of all
was that of the Earl of Rochester, who played the part of the quack
not only on paper, but also in costumed reality. Fleeing arrest and

Noelle Gallagher

27

possible trial for murder in 1676, Rochester disguised himself as a

quack doctor named Alexander Bendo and began selling his wares
on Tower Hill. He quickly attained a popular following, offering free
medical advice and selling remedies concocted from urine, asafoetida,
and other noxious substances.50 At the same time as he evaded the
law and hoodwinked the public, Rochester also satirized the court,
publishing a mock advertisement in which he aligned politics and
government with quackery.51 Alexander Bendos Brochure observed that
both the mountebank and the politician recognize how the people
are taken with specious, miraculous, impossibilities, and promise
things that can neer be brought about; So you see the Politician
is, and must be a Mountebank in State Affairs; and the Mountebank
(no doubt if he thrives) is an errant Politician in Physick.52 Bendos
advertisement simultaneously criticized, and acknowledged complicity
in, societys moral ills, hinting suggestively, for example, at the doctors possession of a great secret to cure barrenness. By offering
his questionable services as a means of treating various ills, Bendos
Brochure mocked a credulous public while also exposing various figures
of authorityliterary, political, medicalas confidence men.53
The Satire-as-Medicine Commonplace in Context
As the many examples I have touched on should suggest, Restoration and early-eighteenth-century references to the satire-as-medicine
commonplace were both extensive and diverse, as writers varied their
use of the trope not only by figuring the relationship between satire
and medicine in different ways (satire as physician, satirist as physician, satirist as patient, satire as prescription or cure), but also by
destabilizing or refuting the alignment of medical and satiric practices.
The remarkable flexibility of the satire-as-medicine commonplaceits
ability to stand in for a wide variety of different concepts or debates
helps explain the tropes longevity within satiric literature and literary
criticism. Throughout the Restoration and eighteenth century, the link
between satire and medicine served not only as a means by which
satirists were able to validate their own work or clear themselves of
charges of bias, but also as a vehicle for exploring broader concerns
about the state of contemporary politics, commerce, or learning.
For some writers, the satire-as-medicine trope offered an avenue
for expressing fears that the practices of medicine and those of literature (and particularly, panegyric and satiric literature) were changing

28

The History of a Metaphor

for similar reasons, and in similar ways. The growth of commerce, for
example, had strongly affected both the medical and literary worlds:
an expanding array of medical practices and practitioners emerged to
meet the increasing demand for treatment.54 Equally, literature was
becoming a profitable line of business, with writers-for-hire catering
to the demands of a larger, and more diverse, body of readers.55 As
commercial writers and medical professionals exploited the increasingly
lucrative markets for their wares, satirists attacked prominent figures
in both fields for subjugating their professions higher moral purposes
to a selfish desire for material gain.
In works like Garths Dispensary (1699), for example, the satire-asmedicine commonplace provided a means of critiquing both mercenary
writers and for-profit physicians. Written in the context of the Royal
College of Physicians decision to open a free dispensary for the poor,
Garths poem dramatized as a mock-epic battle the conflict between
two opposed camps of college members: the Society Physicians,
who supported the creation of the dispensary, and the Apothecaries
Physicians, who opposed the venture as a threat to their profits. In
the preface to the 1718 edition of the poem, Garth explicitly identified
his satire as treatment for a profession that had itself grown sick,
and the poems speaker repeatedly attributes the current dis-ease within
the College to a shift from altruistic to commercial medicine.56
Writing as both a physician and a satirist, Garth questioned the
commercialization of literature as well as of medicine, and the poem
frequently aligns physicians engaged in Mercenary Projects with
hack writers.57 Not only do the Apothecaries Physicians count a hack
poet (Blackmore) among their number; they also make their money, at
least in part, by scribbling. As the villainous Mirmillo declares when
rousing the dispensarys opponents to battle, Physicians, if theyre
wise, shoud never think / Of any other Arms than Pen and Ink.58
By aligning the writing of profitable prescriptions with the writing of
hack literature, the Dispensary incorporated the satire-as-medicine trope
into a broader attack on the commercialization of learning.
Popes Epistle to Arbuthnot similarly invokes the satire-as-medicine
commonplace to denounce the desire for personal gain, but its critique
focuses more narrowly on the distinction between literature written for
altruistic purposes and literature written with the intention of securing
wealth or fame.59 While the evolution of a competitive marketplace
might legitimately be seen as a threat to all literature, commercialization
and party politics seemed particularly to compromise the therapeutic
purposes of satire and its sister genre, panegyric, as hack writers were

Noelle Gallagher

29

tempted to exploit a growing market demand for bespoke flattery or

slander. As a defense of Popes own satiric principles, the Epistle sought
to highlight these moral and literary concerns. The poem draws on
the familiar satire-as-medicine trope in order to defend disinterested
satiric literature as curative; at the same time, it attacks mercenary
writing as a kind of infectious disease.
Structured as a kind of epistolary conversation between Pope and
his more cautious friend, the Epistle celebrates the connection between
satire and medicine that would have been embodied by the poems
addressee, the physician and poet John Arbuthnot.60 In addition to
reaffirming the conventional links between morally elevated satire and
social medicine, however, Popes account also champions satire as a
form of therapy for the writer:
The Muse but served to ease some friend, not wife,
To help me through this long disease, my life,
To second, Arbuthnot! thy art and care,
And teach, the being you preserved, to bear.61
Here purgative satire and professional medicine are presented as
complementary forms of therapy, with both treatments contrasted
againstand perhaps used as antidotes tothe infectious mania of
hack writing: in the famous opening lines of the poem, Pope compares
his mercenary contemporaries to escapees from Bedlam, lamenting the
vast number of fame-hungry writers who rave, recite, and madden
round the land.62
At the same time as writers like Garth and Pope used the satireas-medicine commonplace to explore (or, more commonly, denounce)
commercialization, other writers adapted the trope to express related
concerns about professional prestige, including the problem of distinguishing between learned and lay medicine, high and low
art.63 The comparison between satire and medicine offered different
opportunities for exploring issues of status; some writers linked professional medicine with satire-as-high-art, while others employed satiric
wit to question the rising power and prestige of ostensibly learned
physicians. Fieldings novels, for example, interrogated professional
medicine by depicting physicians and surgeons as stock figures of
social and intellectual pretension.64 In Joseph Andrews, a work that
explicitly identifies affectation as the chief butt of its satire, Fielding
targets not only the social pretentions of Mrs. Slipslop, but also the
intellectual pretentions of the surgeon summoned to treat the injured

30

The History of a Metaphor

Joseph. Keen to establish his own importance, the surgeon not only
exaggerates the severity of his patients injury; he also delivers his
diagnosis in a convoluted mixture of ostentatious Latin phrases and
impenetrable medical jargon: The Contusion on his Head has perforated the Internal membrane of the Occiput, and divellicated that radical
small minute invisible Nerve, which coheres to the Pericranium; and
this was attended with a Fever at first symptomatick, then pneumatick,
and he is at length grown deliruus, or delirious, as the Vulgar express
it.65 Like Mrs. Slipslops vocabulary of malapropisms, the surgeons
convoluted languagethe means by which he seeks to demonstrate
his intellectual superiority to his audienceironically becomes the very
means by which his real inferiority of mind is exposed.
Similarly, the medical practitioners who appear in Fieldings
Tom Jones (1749) seem designed to prompt readers into questioning
the prevailing conception of medical knowledge as a marker of elite
intellectual status. When two doctorsthe generically named Dr. Y.
and Dr. Z.are feed at one and the same instant to attend on
Captain Blifil, their dispute over the cause of the captains death suggests that the practice of medical diagnosis is as dependent on the
individual physicians whims as on his store of medical knowledge:
To say the truth, every physician, almost, hath his favourite disease,
to which he ascribes all the victories obtained over human nature.
The gout, the rheumatism, the stone, the gravel, and the consumption
have all their several patrons in the faculty; and none more than
the nervous fever, or the fever on the spirits. And here we may
account for those disagreements in opinion, concerning the cause of
a patients death, which sometimes occur between the most learned
of the college, and which have greatly surprised that part of the
world who have been ignorant of the fact we have above asserted.66
Like the surgeons unwittingly ironic reference to the Vulgar in Joseph Andrews, the narrators distinction between learned physicians
and ignorant laypeople ultimately serves to undermine, rather than
validate, medical practitioners claims to intellectual superiority.
More broadly, we might usefully consider the satire-as-medicine
commonplace as a forum for examining the major philosophical issues
of the period, including the mind-body problem and the relationship
between material and spiritual realms. After all, the practice of medicine
was becoming increasingly material not only in its commercialization,
but also in its gradual acceptance of empirical philosophy.67 Although

Noelle Gallagher

31

most people in the seventeenth and eighteenth centuries continued to

draw connections between morality and health, many learned medical practitioners were reconsidering the belief that illnesses were the
result of temperamental or behavioral failings.68 Privileging sensory
observation and clinical experience over ancient medical theories,
these early medical professionals began to focus more narrowly on
the body as itself the best means of diagnosing and treating forms of
disease.69 Physicians like Herman Boerhaave, for example, effectively
narrowed the scope of medicine to physiology alone by contending
that the body of man was a machine, and thus, that bodily health
was purely mechanical.70
Much like the tensions between high and low, or between
learned and unlearned, then, the tensions between spiritual and
material approaches to human health might be presented as either
reaffirming or destabilizing the satire-as-medicine trope. On the one
hand, scientific and satiric diagnoses might be seen as complementary:
in Popes Epistle to Arbuthnot, as we have seen, satiric catharsis is
presented as a therapeutic accompaniment to conventional medicine.
On the other hand, shifting views of the relationship between bodily,
mental, and moral states could undermine the basis of the satire-asmedicine commonplace, throwing the link between the satirist and
the physician, or the definitions of satire or medicine as therapeutic,
into doubt. Sternes Tristram Shandya novel that derives much of its
comedy from attempts by physicians and others to find simple material solutions to larger philosophical problemsmight be read as an
exploration of exactly these issues.71 Tristrams traumatized homunculus
and crushed nose, his accidental circumcision, his interest in baptism in
utero, his attraction to the fantasy of Momuss glass: all these elements
in the narration might be understood as contributing to the works
broader satire on our common human need to search for some simple,
straightforward link between spiritual and material experience. The
character of Dr. Slop, championing medical advances like the forceps
as quick-fix solutions to the problems of life, becomes, in this reading
of the novel, a quixotic figure. His faith in the materiality of modern
medicine suggests that perhaps for Sterne, as for Fielding, the type
of the modern doctor was an irresistible target for satire.72
Ultimately, then, we might consider seventeenth- and eighteenthcentury references to the satire-as-medicine commonplace in relation
to a wide range of social, political, economic, and aesthetic concerns.
While there is insufficient space here to survey all of the ways in
which early modern satiric and medical practices intersect, it is worth

32

The History of a Metaphor

observing that this trope can be located on the fault lines of a number of important cultural divides: between the arts and the sciences,
between the ancients and the moderns, between the learned and
the vulgar, and between the spiritual and the material. For satirists
who understood the practices of medicine and literature as aligned,
medicine and medical practitioners could be used as symbols of, or
stand-ins for, the literary world. For satirists who saw, or wished to
create, a division between literature and medicine, medical practices
and practitioners could be held up as objects of ridicule. Regardless of
whether they were cast as complementary therapies or prescribed as
alternative models of treatment, the harsh Remedies of both satire
and medicine played a key role in shaping the English satiric tradition,
throughout the long eighteenth century and beyond.
NOTES
I would like to thank Ian Burney for his helpful comments on an earlier
draft of this essay.
1. For Drydens remarks in full, see Dryden, Works, 2:5.
2. Randolph, The Medical Concept, 12557. John F. Sena has examined
the concept of the satirist-as-physician in relation to Smolletts Humphry Clinker in
Smolletts Matthew Bramble, 38096.
3. Randolph, 126.
4. By emphasizing the medical metaphor here, I do not mean to suggest that
it was the only such critical commonplace used in satiric theory. Another prominent trope characterized satire as a looking-glass. See, for example, Jonathan Swift,
A Tale of a Tub, 140; Fielding, Joseph Andrews, 189; Kelly, Thespis, 4; The Mirror, 3;
Theophilus Swift, The Temple of Folly, xii.
5. For summaries of this view, see Porter, Disease, Medicine, and Society, 2426;
Lindemann, Medicine and Society, 910.
6. On the link between illnesses and individual identity, see Porter and Porter,
In Sickness and in Health.
7. See Wear, Knowledge and Practice, 154209.
8. On the broad range of medical theories and treatments, see King, The
Medical World, 158; Wear, Knowledge and Practice, 7882; Porter and Porter, Patients
Progress. On the relationship between mind, morals, and body, see Porter and Porter,
In Sickness and in Health, 6075; Wear, Knowledge and Practice, 17884 and 28188.
9. See Porter and Porter, In Sickness and in Health, 2142; Wear, Knowledge
and Practice, 17884.
10. Blackmore, Prince Arthur, 2v.
11. Tate, Characters of Vertue and Vice, A2r.
12. Dryden, Works, 4:55.
13. DUrfey, Scandalum magnatum, 8; see also the prologue to Dryden, Albion
and Albanius: Satire was once your physic, wit your food: / One nourishd not,
and tother drew no blood. / We now prescribe, like doctors in despair, / The
diet your weak appetites can bear (c2r).
14. Emes, Letter to a Gentleman, 5. For other descriptions of satire as a cure
or remedy, see, for example, Newcomb, The Manners of the Age, 58687; Harwood,
To the Worthy Author, A6r-v.

Noelle Gallagher

33

15. See, for example, Whyte, A Burlesque Upon Musick, in Poems, 215;
Brownsword, Laugh and Lye Down; A Wipe for Iter-Boreale Wilde; A Pill to Purge
State-Melancholy.
16. On the distinction between physicians and surgeons, see Wear, Knowledge
and Practice, 21074; Christopher Lawrence, Democratic, Divine and Heroic, 147.
17. Dryden, 4:7172; this edition translates Ense rescindendum as it must be
cut off with the sword (4.573).
18. On the range of medical practitioners in this period, see Porter, Disease,
Medicine and Society, 1820; Porter and Porter, Patients Progress, 20809.
19. Dryden, Works, 4.75. See also Dacier: those, who do not endeavour
to correct themselvs [sic] by so beautiful a Model, are just like sick Men, who
having a Book full of Receipts, proper to their Distempers, content themselves to
read em,/ without comprehending them, or so much as knowing the Advantage
of them (E6r-v).
20. Scroope, In Defence of Satire, 1:115.
21. See Jewson, Medical Knowledge and the Patronage System, 36985.
22. See Sloan, English Medicine, 59.
23. On the importance of purging corrupted or putrified matter, see Wear,
Knowledge and Practice, 136-43; McMaster, The Body Inside the Skin, 281.
24. Newbery, Poetry Made Familiar and Easy, 131. Amending these words
somewhat, an early American encyclopedia described satire as curing by bitter
and unsavoury, or by pleasant and salutary, applications (Encyclopaedia, 15:249).
25. Johnson, Dictionary. See also Allen, Complete English Dictionary.
26. For examples of such language, see Denis, Select Fables, 326; Dryden,
Works, 2:59, 4:62, 4:63, 4:65, 4:68, 4:79; A Letter to a Friend in the Country, 1011;
Fortescue, Dissertations, Essays, and Discourses, 209.
27. Dryden, 4.71. Drydens reference to Jack Ketchthe executioner famous
for taking eight fumbling strokes to complete the decapitation of the Duke of
Monmouthadds an extra layer of complexity to his metaphor here, as it suggests
that the satirists focus should not be on executing with precision, but rather on
executing in such a way as to cause the greatest pain to the victim.
28. Falconer, Ode, 6.
29. Spirit and Unanimity, 28.
30. Merit, 3. See also A Letter to a Friend in the Country, 1011; The Modern
Englishman, 6; The Neuter, B1r; Newcomb, A Supplement, 10.
31. For descriptions of satirists performing such tasks, see, for example, To
Mr. Pope, By a Lady, xiv; Harwood, To the worthy Authour, A6r-v.
32. On Popes poisoning of Curll, see Popes own satiric pamphlet, A Full
and True Account of a Horrid and Barbarous Revenge by Poison On the Body of
Mr. Edmund Curll, in Prose Works 1:25766; for subsequent discussions of this
episode in literary history, see Baines and Rogers, Edmund Curll, 8085; Mack, Alexander Pope, 295301. I am grateful to Tom Keymer for the suggestion that Youngs
remark may refer to this incident.
33. Young, Conjectures on Original Composition, 9798. Youngs statement
was frequently quoted in subsequent texts, suggesting that it struck a chord with
many readers. See, for example, Anecdotes of Polite Literature, 2:7475 and Biographia
Britannica, 1:55.
34. See, for example, Neville, Remarks, 565.
35. The use of the term scourge in this context was so commonplace as
to render citations hardly necessary. Among the texts cited elsewhere in this essay,
see, for example, A Letter to a Friend in the Country, 10-11; The Modern Englishman,
6; The Neuter, B1r; Newcomb, A Supplement, 10; Falconer, Ode, 6; To Mr. Pope,
xiv; entries for to lash in Johnsons and Allens dictionaries; Denis, Select Fables,
326; Fortescue, Dissertations, Essays, and Discourses, 209.
36. See, for example, Dryden, 4.3536; 4.63; Harwood, To the Worthy Author, A6r; Cooper, Observations on the Present Taste for Poetry, 5, 38; Introduction

34

The History of a Metaphor

to the English translation, A2r-v. Sena characterizes the physician-satirist as a man

of acute physical or moral sensitivity, whose exposure to moral ills causes him to
fall prey to disease or debility himself. See Smolletts Matthew Bramble, 38096.
37. On the slippery distinctions between physicians and quacks in the eighteenth century, see Loudon, The Vile Race of Quacks, 10628; Porter, Quacks;
Porter, Health for Sale.
38. Newcomb, A Supplement, 7. R-ck and M-rg-n are de-anonymized as Rock
and Morgan and cynically described as Two famous Quacks in the footnotes to
the 1739 Dublin edition; Haines is listed as Printer of the Craftsman.
39. Newcomb, A Supplement, 12.
40. Newcomb, Danvers and Moore, 2933.
41. Sedley, Upon the Author, 1:103. For Garths caricature of Blackmore, see
The Dispensary (1699), canto 4, lines 17291. Subsequent references to this edition
are by canto and line number.
42. I am using the term mountebank here in its original sense, as referring
specifically to An itinerant charlatan who sold supposed medicines and remedies.
See meaning 1a. in the Oxford English Dictionary Online.
43. Swift, A Tale of a Tub, 34.
44. Ibid., 38.
45. A similar comparison appears in Dennis, Iphigenia: I find it is the daily
practice of our Empiricks in Poetry to turn our two Theatres into downright
Mountebanks Stages, to treat Aristotle and Horace with as contemptuous arrogance,
as our Medicinal Quacks do Galen and the great Hippocrates (A4r).
46. Four years later, Swift assumed the voice of another dubious man of
science, Isaac Bickerstaff, in order to parody the astrologer and quack physician
John Partridge. See Bickerstaff Papers, 14064.
47. Pope, Prose Works, 1:15568.
48. Ibid., 1:164.
49. Ibid., 1:167.
50. Rochesters period as Alexander Bendo is well documented by the Earls
many biographers, from Gilbert Burnet onwards. See, for example, Goldsworthy,
The Satyr, 200203; Greene, Lord Rochesters Monkey, 108-113; Lamb, So Idle a Rogue,
17882; Pinto, An Enthusiast in Wit, 81-90.
51. On Alexander Bendos bill as a political satire, see Combe, A Martyr for
Sin, 124-31; Bourne, If I Appear to Any One Like a Counterfeit, 317; Thormlen,
Rochester, 15455.
52. Wilmot, Alexander Bendos Brochure, 114.
53. The notorious satire that led to Rochesters earlier expulsion from the
court in 1673 was also (erroneously) known as A Satire on the King, for which
he was banished the Court, and turned Mountebank. See The Works of the Earls
of Rochester, Roscommon, and Dorset, 1:81; Lamb, So Idle a Rogue, 11415; Greene,
Lord Rochesters Monkey, 108.
54. On the medical marketplace of the seventeenth and eighteenth centuries,
see Porter and Porter, Patients Progress; Holmes, Augustan England, 166205; Cook,
2869; Jenner and Wallis, The Medical Marketplace, 123.
55. On the rise of a literary marketplace, see Rogers, Grub Street; Raven,
Judging New Wealth, 19-82; Collins, Authorship in the Days of Johnson, 21370; Feather,
The Provincial Book Trade in Eighteenth Century England. On the links between the
literary and medical marketplaces, see Porter and Porter, Patients Progress, 110;
Fissell, The Marketplace of Print, 10832.
56. Garth, Dispensary (1718), a1v; for examples of the poems critique of
mercenary medicine, see the 1699 edition, 1:34 and 1:6366.
57. Garth, Dispensary (1699), 2:93.
58. Ibid., 4:7071.
59. See Pope, Imitations of Horace. Subsequent references to the epistle are by
line number and use this edition.

Noelle Gallagher

35

60. Several critics have remarked on the use of medical language or rhetoric
in the epistle. See, for example, Knoepflmacher, The Poet as Physician, 44049;
Douglass, More on the Rhetoric and Imagery of Popes Arbuthnot, 488502.
61. Pope, Imitations of Horace, 13134.
62. Ibid., 6.
63. On the changing status of learned medical professionals, see Wear, Knowledge and Practice, 2129; Holmes, Augustan England, 206-35; Cook, Decline of the Old
Medical Regime. Cooks account complicates Holmess narrative of advancement,
arguing that while learned medical practitioners gained in social prestige, the college of physicians as a body lost much of its power.
64. Trainor speculates on Fieldings opinion of doctors in Doctors in Fieldings Fiction, 11116.
65. Fielding, Joseph Andrews, 63. A similar scene appears in Tom Jones, with
a jargon-happy surgeon called to attend to the wounded Tom: see Fielding, Tom
Jones, 1:38081.
66. Fielding, Tom Jones, 1:112.
67. See Wear, Knowledge and Practice, 47273.
68. Lindemann, Medicine and Society, 7576.
69. On the developments in medicine during the late seventeenth and eighteenth centuries, see King, Road to Medical Enlightenment; Sloan, English Medicine in
the Seventeenth Century, 7090, 17077; Lindemann, Medicine and Society, 101; Lawrence, Charitable Knowledge; Foucault, The Birth of the Clinic. Andew Wear usefully
notes that the commercial need to attract patients effectually transcended many
of the shifts or tensions between competing medical theories. See Wear, Medical
Practice, 294320.
70. King, Road to Medical Enlightenment, 68. On the mechanical model more
generally, see King, The Philosophy of Medicine, 95124; Wear, Knowledge and Practice,
47273. It is worth observing that historians of medicine continue to dispute the
degree to which mechanical theories actually affected medical practice.
71. Rodgers, by contrast, convincingly argues that we might align Sternes
approach to the novel with contemporary physiologists approach to human life.
See Life in the Novel, 120.
72. Many critics have explored the theme of medicine in Tristram Shandy.
See, for example, Porter, The whole secret of health, 6184; Rodgers, Sensibility,
Sympathy, Benevolence, 11758; Hawley, The Anatomy of Tristram Shandy, 84100.

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