Constructions of Cancer opens with a grisly scene. A Gloucestershire woman lies on an operating table and undergoes a mastectomy without the use of anesthesia. Her endurance is admirable, so much so that one of the surgeons commends her for it. How did this woman end up on an operating table? Why would she submit to such an ordeal? Alanna Skuse attempts to answer such questions by exploring what cancer meant to English sufferers and healers from 1580 to 1720. She reconstructs characterizations of the disease in medical and literary texts, and examines how ideas about the body and medicine, as well as the state and gender, shaped those characterizations.

Skuse finds that cancer was conceptualized as both constitutive of the body and independent of it. There were humoral theories that linked the disease to fluxes and plethoras within the body and that treated it using purges, bloodletting, and changes in diet to alter internal flows. Yet those theories coincided with conceptions of cancer as a foreign entity, discrete from the body it invaded. These two views were further riddled with contradictions and complexities that only confirmed the instability and mystery of cancer, not to mention the flexibility of early modern theories about it.

Skuse begins her book by discussing the oldest and most popular image bound up in characterizations of cancer: the crab. Tumors were round and dark like crab shells and bulged with blood vessels that resembled crab legs. And, like a crab, the disease gnawed away at the flesh and assaulted the body with a tenacious grip. The author returns to animal imagery a few chapters later in her discussion of wolves and worms. Cancer possessed the figurative qualities of these two creatures — it was ravenous and secretive — yet the disease also was viewed quite literally as a flesh-eating animal. Some medical authors believed that tumors were actually comprised of tiny worms, while others promoted the use of “meat cures” that involved placing freshly killed animals directly onto the body. The enticing meat lured the cancer out. Another recurring theme is how assumptions about women shaped understandings of cancer. Skuse argues that women were considered susceptible to the disease as a result of their generative bodies and social roles as wives and mothers. A final chapter on surgery offers a subtler gender argument: male surgeons’ knowledge of and intimate access to female bodies put them in a precarious position of power, which led some surgeons to implicitly characterize their work in sexual terms of domination and desire.

Constructions of Cancer is a cultural history of disease that expertly draws on both literary methods and historical evidence. This is a timely and appealing approach, though it runs the risk of leaving scholars in each discipline longing for more. Literary scholars may wish for more sustained discussions of poetry, plays, and broadsides that demonstrate the use of cancer to convey dangerous, hidden threats. Historians, in turn, may hope for a deeper engagement with archival records to recover not only textual representations of cancer, but also perceptions and experiences of the disease. Historians of medicine may yearn for a broader rather than deeper focus. Situating cancer within the wider world of early modern medicine may complicate some of the book’s intriguing findings. A chapter on nonsurgical treatments, for example, suggests that remedies aimed at eating away cancers reveal views of the disease as an invading entity. These medicines targeted tumors as opposed to the whole, unique patient. Rather than tailoring these remedies to individual humoral makeups, healers touted them as cure-alls. Marketing cures as one size fits all may suggest a view of cancer as parasitic, but it also reflects the growth of patent medicines and increasingly blurred divisions between irregular and learned practitioners.

Perhaps the book’s most valuable contribution is its eloquent recovery of the circular relationship between culture and disease. Metaphors and language that drew on ideas about morality and God, or rebellion and secrecy, were employed in medical writing to characterize cancers. Cancer, in turn, offered up a host of powerful images for articulating disorder in writing about religion and the body politic. Such exchanges offer rich and welcome insights into the early modern imagination.