Alanna Skuse. Surgery and Selfhood in Early Modern England: Altered Bodies and Contexts of Identity. Cambridge: Cambridge University Press, 2021. 201 pp. ISBN: 9781108843614. £75 hardback.
In Surgery and Selfhood, Alanna Skuse offers a rewarding intervention into critical debates about embodiment in early modern England. Her subject of study is an intriguing one: how were bodily alterations after surgery perceived and experienced in early modern England, and what might this tell us about the status of the body – impaired and whole – in the period’s culture? By drawing on texts from poetry and drama to surgical handbooks and philosophical treatises, Skuse’s study attends to the wide variety of ways bodily identity is formed, witnessed, morally interpreted, and erased. This is no easy task: while the historical medical procedures that were used are well documented, past cultural attitudes towards amputees, for example, are harder to uncover, while the voices of people with bodily impairments are very rarely heard in early modern writing. Building on disability studies and phenomenological theory (including the work of Maurice Merleau-Ponty, Paul Ricoeur and others), Skuse shows how the early modern altered body is both ‘me’ and ‘mine’, ‘here’ and ‘there’: it is felt and alive – at times even through a sense of its alienness – and simultaneously an object of curiosity and spectacle to others.
Skuse begins her exploration with an eye-watering set of instructions for the budding ship’s surgeon. ‘Imagine that you are at sea’, says John Moyle in An Abstract of Sea Chirurgery (1686). The ship’s company is preparing for battle. What must you do? Spread a sail on a flat surface and place two barrels on it to make your operating table and dressing station. Then fill two tubs with water, one as a temporary storehouse for amputated Limbs, the other for washing your ‘dismembring’ equipment, presumably between goes (1). You are ready for the battle, and you must be prepared to ignore wounded men’s shrieks as they go under the knife. Skuse has an eye for arresting anecdotes, and she is also alert to their subtexts and omissions. The salt-water-lashed surgeon’s attention had to be fixed on the immediate task: his job was to save lives even as he sawed off limbs, and to give the victims of dreadful injuries the aftercare they needed in order to heal. But the printed textbooks on surgery end there. Battle surgery allowed little time to notice the healed but impaired mariner, who would leave the ship and attempt to forge a life for himself. Nor did it leave a moment to reflect on that tub of discarded limbs which would soon be pitched overboard into the sea.
This book, however, pays attention to both. What was life like for people who survived amputation and other forms of physical impairment in the sixteenth to eighteenth centuries? How did they feel about their bodies, and what were other people’s attitudes towards them (them as people; them as bodies)? And what implications did those separated body parts have for the way early modern people considered flesh and feeling to function? One of Skuse’s most important arguments in this book is that these ‘altered bodies’ occupy the contested and slippery boundary between subject and object, and present ‘a shaping influence on the mind or a constitutive part of it’ (10). Early modern people, she contends, demonstrated both flexibility and nuance in their responses to bodily alteration, where the axis of normalcy and non-normalcy is far from static.
Surgery and Selfhood is constructed, not as a chronological sweep from the Renaissance to the Enlightenment, but as a ‘collection of interventions’ (12; Skuse is quoting Mark Breitenberg’s phrase from Anxious Masculinity in Early Modern England [1996]). These are organised by forms of bodily alteration: from castration and mastectomy in Chapters 1 and 2, to facial surgery and prosthetic limbs in Chapters 3 and 4. Chapter 5 is a study of ‘the altered body after death’ (Chapter 5), leading lastly to a fascinating discussion of the phenomenon of phantom limb pain (Chapter 6). This structure makes for a lively and engaging read, though the reader’s natural tendency to look for a linear pattern may be challenged by the ordering of material. I was not wholly convinced by the author’s decision to start in Chapter 1 with a discussion of eighteenth-century male singers who had been castrated in childhood in order to produce a distinctive quality of voice. This is partly because the material falls late in the early modern period, and partly because the castrato body was, as Skuse acknowledges, a rare case, ‘“created” by surgery to fulfil a purpose’ (16). It might have been more effective to consider the castrati after providing an insight into the earlier narratives of those who underwent surgery out of necessity, such as the early modern women who had mastectomies for breast cancer. Moreover, while we are offered a variety of evidence to suggest how castrati were treated as ‘sex objects’ (23) in eighteenth-century society, we hear little about them as performers on stage, or about the roles specially written for them. Their status as musicians is obscured by an approach which, while informative, felt like it had a missing centre.
Yet Skuse has much of interest to say elsewhere about how bodily alteration is enacted in performance, above all in her reading of William Shakespeare’s Titus Andronicus in Chapter 4. Focussing on the moment when Titus’s daughter Lavinia takes up a staff in her mouth to write the name of her attackers on the ground, Skuse asks why the character makes this exact choice. We might be tempted to answer, ‘because they have cut off her hands’, but Skuse is quite right to notice that this unwieldy solution is not the most obvious or easy one. Why does she put the staff in her mouth to guide it? The writing implement, Skuse argues, becomes a prosthesis that is deliberately marked as ‘non-human and distinct from Lavinia’s body’ (103). Shakespeare means it to appear awkward. Whereas some prostheses were designed to be near-invisible, forming a seamless transition from artificial to natural body, Lavinia’s improvised tool deliberately points to her mutilated self. Skuse’s reading provides a rich insight into how this traumatised woman uses a prosthetic to reclaim her subjecthood and express her interiority, even as others try to ‘read’ her as a sign.
The physical objects used by those who had undergone surgery provide an illuminating point of focus, and include crutches, glass eyes, false teeth, and legs constructed of wood and metal and designed to flex with movement. The book also traces the fate of spare and cast-off limbs – among them a right leg found in the window of a cellar near a hospital in January 1720; how it got there, and to whom it belonged, were a mystery. Chapter 5, in particular, looks at attitudes to ‘scattered parts’ (109): the afterlives of removed flesh, and what might happen to altered bodies at the final resurrection. John Donne (of course) features, preaching on the fate of the ‘partitioned body’ (113) distributed in bits across the globe, and asking his listeners to consider how God will reunite ‘in an instant armes, and legs, bloud, and bones’ (113). Skuse draws on a wide variety of sources in this chapter, which makes for some memorable examples; I particularly enjoyed Isaac Watts’s ingenious idea that bodies with parts missing would be made whole at the resurrection by being patched up with excess flesh from ‘corpulent or dropsical bodies’ (120). However, the chapter needed more theological cohesion in order to be truly persuasive. Skuse gives attention to the Miracle of the Black Leg from the Golden Legend, in which Saints Cosmas and Damian replaced the cancerous leg of a sacristan with the limb of a recently interred Ethiopian. She finds its ‘apparent pragmatism’ about the interchanging of flesh ‘deeply problematic’ (128), but I would have liked more reflection on how early modern English Protestant readers might have responded to this medieval Catholic tale. Its inclusion alongside writings by Donne, Watts, and John Bunyan made for a rather diffuse discussion, in comparison to the other critical ‘interventions’ in this study.
While Skuse’s wide range of primary texts does not extend to Edmund Spenser’s writing, Spenserians will find interest in this volume’s approach to embodiment in the early modern period, and particularly in the attention Skuse pays to the constantly shifting ‘lines between bodily wholeness and partition, impairment and disability, and health and illness’ (164). The book’s fine conclusion points forward towards evolving questions of bodily identity in our own age, when ‘transhumanist’ projects are under development to design metal exoskeletons for enhancing the powers of human soldiers or for people with spinal injuries; future body alterations might promise not just implants to restore and improve the senses, but also the means to communicate without words. These reflections on the boundaries between the natural and augmented body, between flesh and prosthesis, may make us return to The Faerie Queene’s false Florimell and Talus in a different light. It is welcome that this volume is available in an open access format through Cambridge Core; its innovative perspective on early modern philosophy, literature, and medicine offers a great to deal to stimulate – and surprise – its readers.
Mary Ann Lund
University of Leicester
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What must you do? Spread a sail on a flat surface and place two barrels on it to make your operating table and dressing station.
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