Richard Dean Smith, MD

Melville's Complaint: Doctors and Medicine in the Art of Herman Melville. New York and London: Garland (Taylor & Francis), 1991.

Preface
The novels of Herman Melville are, to a great extent, fictionalized autobiography revealing the conditions and events of the mid-nineteenth century. In addition, Melville is recognized as one of the most complex and enigmatic authors of American literature. Melville's writings cover a phenomenal range of subjects; many have received detailed comment for other features, but little on his use of medical themes. An astute commentator on human nature, Melville doubted the worth of medicine and the claims of science. Sir Thomas Browne, a seventeenth-century physician noted for his grand and eloquent use of language, however, was one of the principal influences on Melville's development in this respect.
A chronological examination of Melville's books in regard to his use of medical subjects reveals his attitudes about illness and medicine. He included many physicians and medical descriptions in his works, as well as a number of medical metaphors which reflect the changes occurring in science and medicine in America during the first half of the nineteenth century. Melville suffered no exotic or mystifying diseases; however, his sailing experiences undoubtedly brought him into contact with many diseased and disfigured individuals. Along with an ability to assimilate dry, uninteresting reports, his literary use of contemporary theories and trends is masterful.
In the eighteenth century, medicine made considerable progress, providing a foundation for advances of the next century. The most famous surgeons in London were William Cheselden (1688-1725) and Percival Pott (1714-1788), although they were over-shadowed by John Hunter (1728-1793), who greatly elevated the practice of surgery. The science of modern pathology was developed by Giovanni Morgagni (1682-1771) in Padua. In Paris, Rene Laennec (1781-1826) invented the stethoscope stimulating advanced studies of the heart and lungs. In Vienna, Leopold Auenbrugger (1722-1826) made important advances in the study of diseases of the chest. Smallpox vaccination, discovered by Edward Jenner (1749-1823), and the development of digitalis, by William Withering (1741-1799), were highlights of eighteenth-century medicine, while scurvy, a serious illness of sailors, was dramatically eliminated by the investigations of Scottish physician James Lind (1717-1794).
In the first half of the nineteenth century, medical progress occurred rapidly from the work of many eminent physicians. The minute structure of the body was revealed by the microscope. In Germany, physiology became a distinct science through the work of Johannes Müller, whose student Hermann von Helmholtz, studying hearing and vision, invented the ophthalmoscope. Rudolph Virchow's studies of the cell refuted the ancient theory of the "humors." Charles Bell in Britain and François Magendie in Paris became pioneers of neurology by their research of the brain and nervous system. In addition, early nineteenth-century investigators developed the concept of germ theory, antisepsis, advances in renal diseases, and a beginning of an understanding of endocrine disorders. Paris was the world's center of medicine, with outstanding medical schools in Leiden, Dublin, Edinburgh and London. The first medical school in America opened in Philadelphia in the eighteenth century and many more were established in the early nineteenth century, developing numerous outstanding physicians and surgeons. The physiological studies of the stomach (1833) by William Beaumont, United States Army surgeon, were original, landmark observations. The greatest contribution of American medicine of the era was the introduction of general anesthesia in 1847. In the eighteenth and nineteenth centuries, the pre-eminent scientists were the naturalists and biologists whose work was eagerly received by the public; many were also physicians.
Herman Melville was born in New York City, August 1, 1819, the second son and third child of Allan and Maria Gansevoort Melvill (the 'e' was added later); both parents came from prominent New England families. Allan, Melville's father, an importer of French goods, attempted to live in a grand manner with servants and carriages while his business was marginal, but he borrowed heavily from family and friends. After moving the family to Albany, where he started a hat manufacturing business, Allan died in 1832, leaving the family burdened with debt. The Allan Melvills added a new member to the family every two years for fourteen years, four sons and four daughters, requiring moves to larger and larger houses. Maria, Herman's mother, was sheltered and protected in Albany. When they moved to New York City in 1861, she was alone and unable to make friends, adapting poorly to life in the city. Maria was nearly always in poor health; family letters referred to her state of "nerves." She died in 1872, aged 81 years.
Herman, the least promising of the Melvill children, lived in the shadow of his brilliant older brother Gansevoort. Perhaps the most notable event of his childhood occurred when he was three-and-one-half months old when he made the "astonishing accomplishment of 'nearly three teeth.'" He was an indifferent student; his mother said, "[Herman] does not appear so fond of his Book as to injure his Health." His father was pleased when Herman chose commerce in school, since he showed little aptitude for learning, saying that "he is very backward in speech & somewhat slow in comprehension, but you will find him as far as he understands men & things both solid & profound, & of a docile & amiable disposition." Once Herman achieved fame from his early novels, no one came forth claiming to have foreseen his ability. He is described as a vigorous, robust youth with straight posture and a solid bearing of strength. Excepting attacks of scarlet fever and other children's diseases, he was healthy until troubled by his back in his middle years. Though at times, Melville could be an affable, convivial companion, he was reserved and introspective; he considered himself a "pondering man."
In some of his works, medicine and medical conditions play a central role in the development of his stories and are discussed at length. In others, medical matters are used as metaphors, to illustrate personal characteristics, and for humor. Medical side-comments having little relation to the story or characterization occur frequently, and a number of these comments are included to illustrate the extent to which Melville employed illness, injury, and medicine in his writings; taken out of context, they lose some of their relevance to the over-all work.

Contents
Introduction: Nearly three teeth.
Chapter 1 Typee:: A savage Æscalapius.
Chapter 2 Omoo:: A doctor in the Calabooza.
Chapter 3 Mardi:: Surgeon Samoa.
Chapter 4 Redburn:: The Frying-pan doctor.
Chapter 5 White-Jacket:: Our Surgeon of the Fleet.
Chapter 6 Moby-Dick::That old Adam.
Chapter 7 Pierre: Tender: as dove's eggs.
Chapter 8 Short Stories: An elbowed old appletree.
Chapter 9 Confidence-Man:: A dose of Y-a-r-b-s.
Chapter 10 Interlude and the Poetry: The kindliest man.
Chapter 11 Billy Budd:: Scientifically conducted.
Chapter 12 Melville and the Doctors: Helen Maria's operation.