Vital Signs offers both a reinterpretation of the 19th-century novel and a methodological challenge to literary historians. Rejecting theories that equate realism with representation, Lawrence Rothfield argues that literary history forms a subset of the history of discourses and their attendant practices. He demonstrates in particular how clinical medicine provided Balzac, Flaubert, Eliot and others with narrative strategies, epistemological assumptions and models of professional authority, and he traces the linkages between medicine's eventual decline in scientific and social status and realism's displacement by naturalism, detective fiction and modernism.