The Medical Case Narrative: Distant Reading of an Epistemic Genre

Abstract

In this article, I argue that we should consider the medical case narrative as an “epistemic genre.” I suggest that historians of knowledge (including medical knowledge) should draw a distinction between “epistemic” and “literary” genres, and that the medical case narrative belongs to the first group, that is, those kinds of texts that develop in tandem with scientific practices. I also argue that the history of the medical case narrative should be studied in a long-term perspective. In general, the focal point of the historiography on the medical case narrative has tended to gravitate around the late eighteenth and nineteenth centuries, with only cursory attention to earlier periods and no attempt to reconstruct the long-term lineaments of the story. I believe that this modernist focus has a very serious flaw, as it ignores the presence of a vast literature of case collections in pre-modern medicine. I believe that we need to trace the history of the medical case narrative as a genre that evolved over a very long period of time, from antiquity to modern medicine. For this purpose, I adopt the approach that literary scholar Franco Moretti has called “distant reading,” that is, a focused attention to the long duration of a genre within a culture as well as its variations across cultures. What do we see when we look at the long-term development of the medical case narrative? Distant reading suggests, at first sight, that the genre appeared in embryonic form in antiquity, with the Hippocratic Epidemics, but also that it disappeared for long periods of time, to emerge again, in new form and with new vitality, in the late Renaissance. Most interestingly, distant reading also suggests that the evolutionary dynamic of the case narrative was closely intertwined with that of two other fundamental epistemic genres, the recipe and the commentary. Here, I examine in particular the association between case and commentary.

The case as a travelling genre

“…For instance, Gianna Pomata’s research has been pathbreaking for a longue durée history of the medical case. Her reflections on the medical case as an ‘epistemic genre’ refine Forrester’s notion of the case as a ‘style of thinking’, in that the concept puts emphasis on the textual nature of the case and the emic and social character of the category of genre (Pomata, 2010, 2013, 2014). Essentially, Pomata suggests that epistemic genres differ from literary genres in that they ‘develop in tandem with scientific practices’, and are ‘directly related with the making and the transmission of knowledge’ (Pomata, 2013: 133).…”

“…: 482). Although medical cases are usefully understood as an epistemic genre because they are ‘vehicles of a cognitive project’, a medical case – like other genres – can have both a history as an epistemic genre and a history as a literary genre, depending on the contexts in which it is used and the purposes for which it is employed (Pomata, 2014: 3). If we take this for granted, Cohen’s broad characterisation of traveling genres in literature can also apply to the medical case narrative, as my case study of an individual medical case shows.…”

Introduction to the special issue on generalisation from dialogical single case studies

“…The discussion in this paper seems to re-orient our thinking: away from generalisation from case studies, towards generating knowledge through cases, insofar as we have described dialogical single case studies as concerned with dynamic and ethical interdependencies that can be accounted for in the identification of chronotopes, and suggested that chronotope may be characterised as a dialogical epistemic genre. Knowledge genres or epistemic genres have been discussed in relation to social epistemology in general (Berkenkotter & Tuckin, 1993), to narratives in medicine (Pomata, 2014) and to single case studies (Morgan, 2012). Although Morgan does not refer to Bakhtin, by 'epistemic genre' she means a thinking style or a way of thinking.…”

Bodies of Texts, Bodies of Tradition - Medical Expertise and Knowledge of the Body among Rabbinic Jews in Late Antiquity

“…For the concept of "qualified experience" in Galen, see VAN DER EIJK, 1997. 72 On the case and the commentary as "epistemic genres", see POMATA, 2014. challenged itself in this process. In the end, the text constructs a possible coexistence of knowledge derived from empirical examination and revelationwithout smoothing away their generic or ontological difference.…”