The medical in Shakespeare’s Twelfth Night

The late Susan Sontag wrote a book that decried the use of illness as metaphor, and argued that we should abandon the practice. If Shakespeare had followed her advice the plays would have been somewhat shorter, for medical metaphors are very frequently employed in them.

In Twelfth Night, the very name of one of the principal characters, Sir Andrew Aguecheek, is a medical reference. What would you expect of a man who suffered chronically from the ague? That he would be lean, sallow, and weak, without much in the way of willpower: precisely the character of Sir Andrew.

There is a medical metaphor in only the nineteenth line of the play. The Duke of Illyria, Orsino, describes the effect upon him of the Countess Olivia, with whom he is in love but who has retired into mourning for a brother who has just died of a cause that we never learn: “Methought she purged the air of pestilence.” Olivia falls in love instead with Viola, disguised as a boy, who is sent to her by the Duke to woo on his behalf: “How now? / Even so quickly may one catch the plague?”

The plague, of course, is love, but (non-metaphorically) also a disease that scholars say exercised a profound and even determining effect upon Shakespeare’s literary career. But never was the effect of new found love on the lover’s mind more succinctly expressed than by the Duke: “For, such as I am, all true lovers are: / Unstaid and skittish in all matters else. / Save in the constant image of the creature / That is belov’d.”

When Feste, the Clown, or Fool, sings his famous song, “What is love? ’Tis not hereafter; / Present mirth hath present laughter,” Sir Toby Belch (a name appropriate to his drinking habits) and Sir Andrew compliment him, for his song is catching:

Sir Andrew: A mellifluous voice, as I am true knight.

Sir Toby: A contagious breath.

Sir Andrew: Very sweet, and contagious, i’faith.

Not all the medical references in Twelfth Night are metaphorical, however. The caring professions are portrayed as drunken. When asked whether a forged letter suggesting that Olivia is in love with her steward, Malvolio, is having an effect upon him, Sir Toby replies: “Like aqua-vitae [distilled spirits] with a midwife.” And when an injured Sir Toby asks the Clown whether he has called the surgeon to attend to his wounds, the Clown replies: “O he’s drunk, Sir Toby, an hour agone; his eyes / were set at eight i’ the morning.” Sir Toby replies, somewhat hypocritically, “I / hate a drunken rogue.”

There is much about madness in the play. When Olivia is told that Malvolio, unusually cheerful, has gone mad, she says: “I am as mad as he / If sad and merry madness equal be.” Shakespeare thus recognises the twin poles of affective disorder.

When Malvolio begins to act yet more strangely Sir Toby says, “Come, we’ll have him in a dark room and bound.” And that is precisely what is done to him. Thus confined, Malvolio is visited by the Clown, in the guise of a clergyman, Sir Topaz (the precious stone was considered a cure for madness). When the Clown reveals himself as such, the following exchange takes place:

Malvolio: Fool, there was never a man so notoriously abused. I am as well in my wits, Fool, as thou art.

Clown: But as well? Then you are mad indeed, if you be no better in your wits than a fool.

In this scene Malvolio, until then a comic figure, turns into a tragic one: a moral lesson, for there is something of Malvolio’s conceit in most of us.