Illness as Metaphor by Susan Sontag

Illness as Metaphor Reviews

• 
  Riku Sayuj

  In 1978, when
  Susan Sontag wrote
  Illness as Metaphor, a classic work, she was a cancer patient herself. But in spite of that, it is not a book about being ill or about the travesties of being a cancer patient. In Sontag's words, it is 'not what it is really like to emigrate to the kingdom of the ill and live there, but the punitive or sentimental fantasies concocted about that situation'.
  
  Her subject is not physical illness itself but the uses of the various diseases as a figure or metaphor for completely unrelated instances. Sontag is very emphatic that 'My point is that illness is not a metaphor, and that the most truthful way of regarding illness-and the healthiest way of being ill - is one most purified of, most resistant to, metaphoric thinking.' Yet, Sontag admits, it is hardly possible. But, her work still attempts to do just that - 'It is toward an elucidation of those metaphors, and a liberation from them, that I dedicate this inquiry.'
  
  Sontag directs her sharp scrutiny on the two diseases have been spectacularly, and similarly, encumbered by the trappings of metaphor: tuberculosis and cancer and to other diseases such as cholera, plague, syphilis and leprosy that are used to a lesser extent.
  
  The book's main contention is that our fantasies are responses to diseases that are mysterious in origin and terminal and capricious in nature. TB in the last century and cancer now fits that bill and hence becomes targets of our collective imagination.
  
  The Metaphors of TB
  
  TB used to be the disease of choice for all sorts of metaphors throughout the last century. Many myths surrounded it.
  
  One of the most potent myths was that it takes a sensitive person to feel melancholy; or, by implication, to contract tuberculosis. The myth of TB constitutes the last step in the long career of the ancient idea of melancholy. The melancholy character - now of the tubercular - was a superior one: sensitive, creative, a being apart. It was so well established that TB and creativity was linked in mysterious ways that it was even suggested at times that it was the progressive disappearance of TB which accounted for the current decline of literature and the arts.
  
  The tuberculic is characterized as a dropout, a wanderer in endless search of the healthy place. Starting in the early nineteenth century, TB became a new reason for exile, for a life that was mainly traveling, as shown in many great travel novels of the era. It was a way of retiring from the world without having to take responsibility for the decision or consequences as in the story of The Magic Mountain.
  
  In contrast to the great epidemic diseases of the past (
  bubonic plague, typhus, cholera), which strike each person as a member of an afflicted community, TB was understood as a disease that isolates one from the community. However steep its incidence in a population, TB - like cancer today - always seemed to be a mysterious disease of individuals, a deadly arrow that could strike anyone, that singled out its victims one by one. The disease that individualizes, that sets a person in relief against the environment, was tuberculosis and today is cancer.
  
  Transformation of the TB Metaphors
  
  The TB myth has been transformed in the modern age but the object of all the transference is not, of course, cancer - a disease which nobody has managed to glamorize. In the twentieth century, the romantic aspects of the TB myth has been transferred to a similarly harrowing and mysterious disease that is made the index of a superior sensitivity -
  Insanity.
  
  Sontag points out that with both TB and with mental illness, there is confinement. Sufferers are sent to a "sanatorium" (the common word for a clinic for tuberculars and the most common euphemism for an insane asylum). Once put away, the patient enters a duplicate world with special rules. Like TB, insanity is a kind of exile. The metaphor of the psychic voyage is an extension of the romantic idea of travel that was associated with tuberculosis. To be cured, the patient has to be taken out of his or her daily routine. It is not an accident that the most common metaphor for an extreme psychological experience viewed positively-whether produced by drugs or by becoming psychotic-is a trip.
  
  With the coming of the twentieth century the myth and the metaphors and attitudes formerly attached to TB has now been apportioned among two diseases:
  
  Some features of TB go to insanity: the notion of the sufferer as a hectic, reckless creature of passionate extremes, someone too sensitive to bear the horrors of the vulgar, everyday world. Other features of TB go to cancer - the agonies that can't be romanticized. Not TB but insanity is the current vehicle of our secular myth of self-transcendence.
  
  Comparisons between TB and Cancer Motifs
  
  The metaphors attached to TB and to cancer are contrasted in great detail by Sontag:
  
  Etymology - 'Cancer' is imagined as malevolent growth, crawling or creeping like a crab and its etymology comes from this image. Tuberculosis was also once considered a type of abnormal extrusion: the word tuberculosis comes from the Latin tuberculum, the diminutive of tuber, bump, swelling - means a morbid swelling, protuberance, projection, or growth.
  
  Symptoms - transparency vs opaqueness - While TB is understood to be, from early on, rich in visible symptoms (progressive emaciation, coughing, languidness, fever), and can be suddenly and dramatically revealed (the blood on the handkerchief), in cancer the main symptoms are thought to be, characteristically, invisible - until the last stage, when it is too late.
  
  Speed and Time - TB is a disease of time; it speeds up life, highlights it, spiritualizes it. Cancer has stages rather than a "gallop". Cancer works slowly, insidiously. Every characterization of cancer describes it as slow, growing menacingly and out-of-control, though this metaphor has speeded up since Sontag's days.
  
  Economics - TB is often imagined as a disease of poverty and deprivation-of thin garments, thin bodies, unheated rooms, poor hygiene, inadequate food. In contrast, cancer is a disease of middle-class life, a disease associated with excess. Rich countries have the highest cancer rates, the toxic effluvia of the industrial economy that creates affluence
  
  Pain - TB is thought to be relatively painless. Cancer is thought to be, invariably, excruciatingly painful. TB is thought to provide an easy death, while cancer is the spectacularly wretched one. The dying tubercular is pictured as made more beautiful and more soulful; the person dying of cancer is portrayed as robbed of all capacities of self-transcendence, humiliated by fear and agony.
  
  Parts of the Body - While TB takes on qualities assigned to the lungs, which are part of the upper, spiritualized body, cancer is notorious for attacking parts of the body (colon, bladder, rectum, breast, cervix, prostate, testicles) that are embarrassing to acknowledge. TB is, metaphorically, a disease of the soul. Cancer, as a disease that can strike anywhere, is a disease of the body. Far from revealing anything spiritual, it reveals that the body is, all too woefully, just the body.
  
  But leukemia seems to approach TB in being romantic and deserving of a more spiritualized metaphor as in  the case of the heroine of 
  Erich Segal's Love Story.
  
  After providing these comparisons and contrasts, Sontag is also quick to admit that these are only metaphors and not accurate reflections of reality - "These are contrasts drawn from the popular mythology of both diseases. Of course, many tuberculars died in terrible pain, and some people die of cancer feeling little or no pain to the end; the poor and the rich both get TB and cancer; and not everyone who has TB coughs. But the mythology persists."
  
  Metaphors of Cancer
  
  Cancer has never been viewed as anything other than a scourge; it had no romantic metaphors and it was always,  metaphorically, the barbarian within.
  
  The language used to describe cancer evokes an economic catastrophe - one of unregulated, abnormal, incoherent growth. It is out of control.
  
  Sontag gives elaborates on this economic metaphor thus:
  

  Early capitalism assumes the necessity of regulated spending, saving, accounting, discipline-an economy that depends on the rational limitation of desire. TB is described in images that sum up the negative behavior of nineteenth-century homo economicus: consumption; wasting; squandering of vitality.
  
  Advanced capitalism requires expansion, speculation, the creation of new needs (the problem of satisfaction and dissatisfaction); buying on credit; mobility-an economy that depends on the irrational indulgence of desire. Cancer is described in images that sum up the negative behavior of twentieth-century homo economicus: abnormal growth; repression of energy, that is, refusal to consume or spend.

  
  When we pause to ponder here, we can see that in the contemporary scenario, the metaphors of cancer applied to the economic scenario has gone back to the earlier ones associated with TB. This shows how easily we adapt our metaphors to equate our worst fears with our worst illnesses.
  
  Sontag goes on to explain that, the controlling metaphors in descriptions of cancer are, in fact, drawn not from economics but from the language of warfare: with words like "bombarding" and "invasion" and 'radical' populating the scientific journals.
  
  The melodramatics of the disease metaphor in modern political discourse assume a punitive notion: to liken a political event or situation to an illness is to impute guilt, to prescribe punishment. This is particularly true of the use of cancer as a metaphor. It amounts to saying, first of all, that the event or situation is unqualifiedly and irredeemably wicked.
  
  This metaphor is not entirely new either: The Nazis had used the cancer metaphor to modernized their rhetoric about "the Jewish problem" throughout the 1930s: to treat a cancer, they said, one must cut out much of the healthy tissue around it to kill the tumor of the Jewish power that "effortlessly and interminably multiplies."
  
  Sontag says that to describe a phenomenon as a cancer is an incitement to violence. And this is clearly ominous as shown in the example above. But, she also goes on to say that "It is, of course, likely that the language about cancer will evolve in the coming years. It must change, decisively, when the disease is finally understood and the rate of cure becomes much higher. It is already changing, with the development of new forms of treatment."
  
  Lasting Influences of the TB Metaphor
  
  Gradually, the tubercular look, which symbolized an appealing vulnerability, a superior sensitivity, became more and more the ideal look for women-while great men of the mid- and late nineteenth century grew fat, founded industrial empires, wrote hundreds of novels, made wars, and plundered continents.
  
  Sontag draws our attention to the fact that the myth of the spiritually beautiful TB patient has now found in the twentieth-century women's fashions (with their cult of thinness) the last stronghold for the metaphors associated with the romanticizing of TB in the late eighteenth and early nineteenth centuries.
  
  Movies like Twilight project this metaphor of the wan, hollow-chested young men and pallid, rachitic young women.
  
  The Death of the TB Metaphor and Hope for Cancer
  
  Sontag says that by validating so many possibly subversive longings and turning them into cultural pieties, the TB myth survived irrefutable human experience and accumulating medical knowledge for nearly two hundred years. The power of the myth was dispelled only when proper treatment was finally developed, with the discovery of streptomycin in 1944 and the introduction of isoniazid in 1952.
  
  For as long as its cause was not understood and the ministrations of doctors remained so ineffective, TB was thought to be an insidious, implacable theft of a life. Now it is cancer's turn to be the disease that doesn't knock before it enters, cancer that fills the role of an illness experienced as a ruthless, secret invasion - a role it will keep until, one day, its etiology becomes as clear and its treatment as effective as those of TB have become. Then the negative metaphors associated with cancer too might die out, or so Sontag hopes.
  
  But inevitably, we will find a new illness to replace it with, after all, the most powerful metaphors are the ones that scare us most. The ideal candidate would be AIDS - which forms the subject of the next Sontag book that I intend to read soon -
  Illness as Metaphor and AIDS and Its Metaphors.
• 
  Dave Schaafsma

  I have owned the highly influential critic, novelist and activist Susan Sontag’s Illness of Metaphor almost since it was published in 1978, but never read it until I got sick with some melanoma recently, the first real time I have ever been “sick” in the serious sense, and even then, not as sick as so many with other, more invasive or vicious cancers. And I knew this book focused on cancer. Sontag died in 2004 of leukemia, at 71, after her mother died of cancer in 1986.
  
  This is an essay I will use to ramp up to read The Emperor of All Maladies, I suppose, though I didn’t love all of it. It was initially published in The New York Review of Books over a few issues. It’s mostly a kind of meditation about how different illnesses are viewed and thought about culturally. TB was seen for a century or more, she contends, as a kind of romanticized disease, one associated for her with artists.
  
  Cancer only meant a death sentence in 1978, when the book was published, which I think has changed now as more people survive it, or at least are kept alive longer with it. Two of my siblings survived fourth-stage cancer--which was supposed to kill you without exception twenty years ago--and three others, including me!--can count ourselves as survivors (that metaphor!), though one of my sisters died of it two summers ago.
  
  I wasn’t so interested in the comparisons she makes about TB vs. cancer as cultural metaphors, since the former is not so much an issue anymore in many parts of the world, especially mine. But she makes it clear that we will all become ill at some point, though most of us do not want to acknowledge or prepare for this fact:
  
  “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.”
  
  Her focus is less about the disease itself and more on how we talk and think about it. Cancer in 1977 was just seen as a death sentence:
  
  “Cancer: the disease that doesn't knock before it enters, cancer that fills the role of an illness experienced as a ruthless, secret invasion.”
  
  Sontag’s references are almost exclusively literary. She looks at how illness is treated in books such as Thomas Mann’s The Magic Mountain, where TB is almost romanticized, and she has plenty of other examples of this. She also writes about insanity and venereal disease and leprosy (as Foucault also does), diseases seen as moral failing, or weakness. The healthy as perfect or at least superior, and the ill as lesser, as deficient. AIDS and syphilis as moral revenge by God.
  
  “In the Middle Ages, the leper was a social text in which corruption was made visible; an exemplum, an emblem of decay.”
  
  “Being happy historically is seen as a ward against illness. The failing of illness is largely seen as an individual’s frailty.”
  
  "The sick man himself creates his disease," Groddeck wrote; "he is the cause of the disease and we need seek none other. . . He alone will die who wishes to die, to whom life is intolerable."
  
  A year before her death in 1923, Katherine Mansfield wrote in her Journal:
  
  “A bad day. . . . horrible pains and so on, and weakness. I could do nothing. The weakness was not only physical. I must heal my Self before I will be well. . . . This must be done alone and at once. It is at the root of my not getting better. My mind is not controlled.”
  
  Mansfield not only thinks it was the "Self" which made her sick but thinks that she has a chance of being cured of her hopelessly advanced lung disease if she could heal that "Self."
  
  "I'm mentally ill, the disease of the lungs is nothing but an overflowing of my mental disease," Kafka wrote to Milena in 1920.
  
  Sontag makes it clear that “The controlling metaphors in descriptions of cancer are, in fact, drawn not from economics but from the language of warfare: every physician and every attentive patient is familiar with, if perhaps inured to, this military terminology. Thus, cancer cells do not simply multiply; they are 'invasive.'"
  
  In much literature, even the much acclaimed “The Death of Ivan Illych,” by Tolstoy, illness can be seen as morally curative: You become a better person. (But I am reminded of a cancer graphic memoir, Cancer Made Me a Shallower Person,” a point Sontag would acknowledge.
  
  When I get sick again, as I will, I will do what I do, use reading as a way to understand, and especially literature, which is more than just the facts. And I'll never hide my health status. I think oversharing can be a real problem, but too many people in my family kept health secrets so as to not bother anyone else. I prefer honesty and openness. Better to be out in the open and not stigmatize illness, as Sontag makes clear.
  
• 
  Michael

  First published as an 87-page monograph in 1978, Illness as Metaphor critiques the dehumanizing myths and metaphors associated with the most infamous illnesses of modernity: TB in the nineteenth century, cancer in the twentieth. As always, Sontag reads as brusque and provocative. Paradoxically, though, the writer spends much time surveying and revisiting the many facets of her field of study. Her argumentation is characterized by digression, repetition, and detour instead of the sequential development of a thesis, but her style of writing never reads as unhurried or belabored. This becomes especially apparent when reading one of her few long essays, and it makes for a highly stimulating, even dizzying, reading experience.
• 
  Steven Godin

  Susan Sontag is angry, and that comes across in this somewhat disturbing essay, where she writes not so much about actual illness, but about the use of illness as a figure or metaphor. She is particularly concerned with the metaphorical sue of tuberculosis in the 19th century and cancer in the 20th. Sontag's evidence for attitudes about tuberculosis is taken from 19th-century novels and operas, where Sontag says that the most truthful way for regarding illness is the one most purified of metaphoric thinking. A disease should be regarded as a disease, not as a sign of some terrible law of nature or an otherwise unnamable evil. I partly agree with her. But a rage inside her drives her to the point of asserting that our views about cancer and the metaphors we have imposed on it, are so much a vehicle for the large insufficiencies of our culture, for our reckless improvident responses to our real problems of growth, for our inability to construct an advanced industrial society which properly regulates consumption, and for our justified fears of the increasingly violent course of history. But there is very little in the way of evidence to support most of her views. The book does has some extraordinarily perceptive things about our attitudes, for example: how we view insanity, for instance, or of heart disease. This is obviously a very personal book, like she was writing it for herself more than anyone else, a book that is almost pretending for the sake of decency to be an important thesis. The fact it's short doesn't help either, the reader is left with a case not fully justified.
• 
  Ahmad Sakr

  كنت متحمس لقراءة الكتاب في البداية بسبب إسمه الجذاب.. ولكنه كله عبارة عن استعارات واقتباسات تاريخية بل وروائية
  الكتاب لطيف وليس سيئا ..ولكني لم استسيغة ولم أكمله للنهاية.. ربما يكون مناسبا في مزاج آخر
• 
  Z. F.

  "Ostensibly, the illness is the culprit. But it is also the cancer patient who is made culpable. Widely believed psychological theories of disease assign to the luckless ill the ultimate responsibility both for falling ill and for getting well. And conventions of treating cancer as no mere disease but a demonic enemy make cancer not just a lethal disease but a shameful one."
  
  Published in 1978, shortly after Sontag herself was diagnosed with leukemia, Illness as Metaphor is a long polemical essay with two central arguments: 1) that certain diseases—notably tuberculosis prior to the 1940s, and cancer in the modern era—have accrued complex networks of cultural associations, which are often moralistic in nature and often totally unrelated to the reality of those diseases; and 2) that this tendency to mythologize illnesses is detrimental to the process of understanding and treating them for what they really are.
  
  The rhetorical force, intellectual rigor, and personal conviction of Sontag's arguments are undeniable; though Illness as Metaphor is more compact than some of her other works, she's no less sharp or formidable here than she ever is, even writing during treatment for an illness she was told may very well be fatal. (Eventually she did lose her life to leukemia, but only after a remission of more than 20 years; her mother, meanwhile, died of lung cancer eight years after this was published.) While I think it's probably impossible to fully remove metaphorical language from our discussions of illness or anything else (as Sontag herself later conceded), she's obviously right in pointing out the harm which inevitably comes from assigning moral significance to the biological functions of viruses, bacteria, and cells in human bodies. I've definitely been seduced by some of the myth-making around TB in particular—many of my favorite artists died of it, and it's tempting to think of the illness itself as a sort of motivator or enhancer of their talents—but I see now that this line of thought quickly becomes problematic. We often speak today of "destigmatizing" (and demystifying) mental illnesses, disabilities, neurodivergencies, addictions, etc.; Illness as Metaphor prefigures that discourse, and I'm sure laid much of the groundwork for it.
  
  The one complicating factor is that—reading this 45 years after publication—I don't actually recognize most of the myths and stereotypes Sontag tells us are associated with cancer. Her portrayal of TB as a disease which was supposed to spur the sufferer to passion while simultaneously purifying the spirit will ring true to anyone who's ever read a Victorian novel, but her framing of cancer as a sort of anti-TB, affecting people who are assumed to be "unemotional, inhibited, [and] repressed" and serving as a sort of shameful punishment for these failings, was new to me. I don't doubt that cancer was viewed this way by many in the 1970s, and maybe Sontag is partly to thank for the fact that things have changed; but nowadays I'd say we're more likely to view cancer patients as beatific and saintly (think of all those sentimental ads for children's cancer hospitals and charities), or as resilient "fighters" engaged in "battle" with the evil disease (a stereotype Sontag does delve into a little, to be fair), or even as figures ripe for romanticizing in much the same way TB sufferers once were (cf. John Green or Nicholas Sparks). If cancer is seen as a punishment today, it's almost always for overindulging in vices like tobacco or alcohol, not for living a life of too much restraint.
  
  Those shifting perceptions aside, I also can't help feeling that it was HIV/AIDS, not cancer, which truly provided the 20th century with a collection of metaphors which could compete with the TB myth of the century before. The terrifying mortality rate (often compared to a "plague"), obvious association with a set of people and activities considered "immoral" or "sinful" by mainstream society, simultaneous association with artists and "bohemians," transmission through blood and sexual fluids, and other symbolically useful features of this new disease caused a powerful and enduring mythology to take hold almost immediately. HIV/AIDS hadn't been classified when Illness as Metaphor was published, but thankfully Sontag was prescient enough to put out a follow-up volume, AIDS and its Metaphors, as early as 1989. I'm reading that one now, and it's an invaluable companion piece—really more of a second half—to this.
  
  But of course it was this book Sontag needed to write first, and I'm happy she did, and even more happy she had the opportunity to follow it up at all. It's always rewarding to spend some time immersed in her thoughts; the experience is inevitably mind-expanding, and empathy-expanding too.
• 
  Haytham

  المرض بوصفه استعارة أو مجاز، يضم هذا الكتاب مقالات نشرتهم الكاتبة والناقدة الكبيرة سوزان سونتاج على حلقات في الصحف حينها وتم نشرهم فيما بعد. الكتاب الأول: المرض كاستعارة عام 1978 والكتاب الثاني: الإيدز واستعاراته عام 1988.
  
  أصيبت سونتاج بسرطان الثدي وقاومته على مدار عقدين ونصف من الزمان تقريبًا، وتوفيت بسببه في عام 2004. وكان الكتاب الأول نتاج تلك التجربة الشخصية حيث خطته في أيام علاجها منه، حيث استعرضت نظريتها النقدية في كتابها الأول الاستعارات المجازية لكل من السرطان والسل في المجتمع مع أمثلة من الأعمال الأدبية الشهيرة ومنها الجبل السحري لتوماس مان وغيرها.
  
  أخذت سونتاج في إلقاء الضوء على تاريخ الأمراض وما كانت تمثله وكيف تفرض تلك الأمراض بعض الأمور وكأنها الشبح الخفي، بل الخوف من ذكر اسمها خوفًا ورعبًا، وما يجب عمله لتصحيح مفهوم المرض، وفصله عن الأوهام والخرافات المنتشرة بين الناس.
  
  فكما نعلم كان مرض السل هو "بعبع" القرن التاسع عشر ومن كان يسمع أنه مصاب بالسل بمثابة الموت المحتوم بلا جدال، وأخذ مرض السرطان تلك المكانة والسمعة في القرن العشرين، وهو مرض ذو فأل شؤم وملعون، فالاستعارات الملصقة بالسل والسرطان تؤدي إلى إجراءات مرعبة. وانتشار فكرة أن السل يصيب الشباب الرومانسي الفنان مرهف الحس؛ ذلك الوصف الرومانسي عكس وبشكل مؤثر على المجتمع تلك الفكرة آنذاك، وأن نزعة داخلية معينة في جسم المريض هي المسببة للمرض. كما بينت كل الخرافات التي كانت مرتبطة بالسل والسرطان والتي تقول بأن الشخص مسئول عن مرضه.
  
  "بالمقارنة مع البعبع المعاصر في شخصية الإنسان المعرض للسرطان في الشخص غير العاطفي والمكبوت والمقموع، فإن الشخصية التي هي عرضة للسل والتي استقرت في تصورات الناس الذين عاشوا في القرن التاسع عشر، كانت خليطًا مت وهمين مختلفين: إنه شخص يجمع بين الاثنين عاطفي ومقموع أو مكبوت".
  
  كما بينت المبالغات الحمقاء في الماضي حول الأمراض السارية، ومجازاتها المتعلقة بالشر وتقليل لقيمة المريض بل ووضعه الاجتماعي أيضًا. وأن الاستعارة العسكرية في الطب دخلت حيز الاستعمال في نهاية القرن التاسع عشر واستخدام كلمات مثل يغزو ويتسلل وحصار المرض ومحاربة المرض، وينظر إلى المرض كعدو يشن الجميع حربًا عليه. كما كانت الاستعارات المجازية للمرض منتشرة في عصر البلاشفة ومجادلاتهم. كما وصف العرب إسرائيل كالسرطان في قلب العالم العربي. وتقول سونتاج: " وكتبت أنا مرةً، أبان حرارة اليأس من حرب ڤيتنام، أن العرق الأبيض هو سرطان التاريخ الإنساني".
  
  "إن استعمال الأمراض القاتلة فقط من أجل الاستعارات المجازية في السياسة يعطي هذه الاستعارات طبيعة حادة أكثر".
  
  وكما أعلاه عملت بالمثل في كتاب الأيدز واستعاراته مع مرض الزُهري أو السفليس الخطير في القرن التاسع عشر، وأن الإيدز جعل السرطان تافهًا ومبتذلاً. وبينت أيضًا هنا أن اعتبار الأمراض عقوبة هو أقدم فكرة لأسباب المرض، وهي فكرة لا تتناسب مع نبل مهنة الطب وما تقدمه من عناية للمرضى، وأن تفسير أي وباء على أنه عقوبة على انحلال أخلاقي أو انحطاط سياسي كان شائعًا حتى القرن التاسع عشر، وأن يكون من الأوبئة الذي كان الجنس من سبل انتقاله شيوعًا.
  
  والخلاصة: أن السرطان هو المرض الحديث لمرض السل ومن قبله مرض الزُهري الذي كان قبله، وأن المجتمع على الدوام ما يأخذ الأمراض المرعبة المميتة تلك، كاستعارات مجازية منتشرة بين الناس.
• 
  Steven

  “But how to be morally severe in the late twentieth century? How, when there is so much to be severe about; how, when we have a sense of evil but no longer the religious or philosophical language to talk intelligently about evil? Trying to comprehend “radical” or “absolute” evil, we search for adequate metaphors. But the modern disease metaphors are all cheap shots. The people who have the real diseases are also hardly helped by hearing their disease’s name constantly being dropped as the epitome of evil. Only in the most limited sense is any historical event or problem like an illness. And the cancer metaphor is particularly crass. It is invariably an encouragement to simplify what is complex and an invitation to self-righteousness, if not to fanaticism.”

  Sontag knows what Lakoff and Johnson would later argue so meticulously in Metaphors We Live By, namely, that metaphors are ubiquitous in language as such, pervading even the most simple and casual utterances. She is not trying to do away with metaphorical language; what she seeks to do is outline the origins and ramifications of metaphor when it is (uncritically?) attached to serious disease, using tuberculosis and cancer as primary examples. Her motivation for writing the treatise is not disinterested – Sontag herself was being treated for breast cancer while she wrote Illness as Metaphor.
  
  To clear language of disease-metaphors is difficult, as Sontag inadvertently demonstrates by employing the adjective virulent to describe the use of disease-metaphors. But getting bogged down in every instance of disease-as-metaphor misses the point. The point is that to use a mysterious disease (in the sense of its causes not being wholly known) like cancer as metaphorical for, or in commentary/condemnation of, society: 1) betters no one, 2) rather, harms those who are suffering from the disease, and 3) is morally wrong.
  
  -----
  
  I’ll add more to the review soon.
  
• 
  Trevor

  There’s really not a lot of point in my reviewing this book when Riku has already done such a wonderful job here
  https://www.goodreads.com/review/show... His review is infinitely more comprehensive than this one will be.
  
  Still, I just want to say that I really did enjoy this. I particularly liked the idea that the metaphors for TB and cancer are so differently understood in our culture. I was particularly struck by the idea that cancer is a kind of hardening of cells and that TB is a kind of liquefying. This got me thinking about Medusa, something I’ve been thinking quite a lot about off and on recently anyway. Something I read somewhere talked about the Medusa and Pygmalion myths – you know, how they are basically opposites. In one a statue becomes a person, in the other a person becomes a statue: human becomes art, art becomes human. And even though cancer is seen as a kind of hardening of the body (you know, we get lumps that spread and grow and take over organs with dead solid masses) this hardening still never really gets compared to Medusa. And I really can’t see why not. It seems to me to be a myth quite well suited to cancer and our visualisations of it. Perhaps it is because such a metaphor offers no hope and no comfort.
  
  Then again, the point of this book is to try to stop us using metaphors to describe illnesses. Not sure how that is possible, metaphors being exactly what we use to understand the terrifying and the unknown, but I can see why avoiding them would seem like a worthwhile aim when the metaphor we generally choose do as much harm as good.
  
  I was worried she was never going to get to the ‘battle’ metaphors that go with cancer. This is something that really drives me nuts. Whatever the treatment of cancer involves – and I do get that it involves pain and hardship – it certainly doesn’t involve a battle. I worry about metaphors like this because they imply that the person doing the fighting, if their illness finally overruns their body, has somehow failed, you know: lost the fight, given up, surrendered to the enemy. All of which is just daft – there is no ‘fight’, we are more or less impotent in the face of a faceless enemy. The poorly assigned metaphor has the potential to bring with it a world of guilt – which, I assume, must have to be just about the last thing a cancer sufferer needs.
  
  
• 
  Jafar

  Mukherjee quoted from this book so many times in The Emperor of All Maladies that I decided to read it. Sontag is an overanalyzing intellectual – that I knew and was prepared for it, but I still didn’t really get this book. She cites tuberculosis an example of an old disease that was laden with myth and metaphor. It was considered the illness of the artist, brought upon by too much passion and sensuality. It was almost cool to catch it. That may have been so. But then Sontag moves to the present-day cancer and its metaphors. Cancer is perceived to be a “disease of insufficient passion, afflicting those who are sexually repressed, inhibited, unspontaneous, incapable of expressing anger…” She goes on in this manner, and it’s the central theme of her study of the metaphors of cancer.
  
  This book was first published in 1978. Did cancer really have these myths and metaphors surrounding it back then? The book came off as really odd and superfluous to me. Sontag is trying to demythologize a myth that no longer exists – or I’m not aware of it. Was it in response to these myths and misconceptions that the cancer awareness movement has swung to the other extreme and has almost become mawkish and infantilizing, especially with regards to breast cancer (pink teddy bears, etc. – c.f. Barbara Ehrenreich’s Smile or Die)?
  
• 
  Lisa Vegan

  I read this when it was first published and I was in my mid-twenties. A lot of what she said about cancer & illness & health really resonated with me; my mother died of cancer when I was 11 and I’d known other people who had also died of cancer. But, society has changed quite a bit since then, in a positive way, so I’m not sure how much the material in here is still applicable. But, at the time, it seemed powerful and insightful.
• 
  نورا ناجي

  عظيم وذكي ومختلف وغني..القراءة لسوزان سونتاج متعة وتثقيف
• 
  Nick

  Recently, I was listening to someone evoke Sontag as they described their Obsessive Compulsive Disorder as purely and only a medical illness, resistant to metaphorical or symbolic conceptions of the disorder. And so I decided to read the essay with this specific lens in mind: Whereas Sontag's emphasis in this essay is physical illness (cancer and tuberculosis), I was most interested in attempting to stretch this same paradigm to understand mental illness.*
  
  Despite the trillions of dollars spent on elucidating the biological 'cause' of mental illness, efforts remain a spectacular failure (e.g., the 'chemical imbalance' myth). Yet, obviously the medical model is important in so many areas, most notably in anti-stigma campaigns. This is most clearly and angrily asserted in Sontag's essay, and I do not think the point is possible to overstate: The double devastation for individuals who find themselves gripped by illness, and then further stigmatised by society viewing their illness through a moralist lens should shame us all.
  
  However, in my view, we abandon the bio-psycho-social model of mental illness, in favour of the bio-bio-bio medical model to our detriment. I think there is an intuitive sense whereby people find reductionistic strictly biological interpretations of illness as limiting of their personality and sense of self. This is reflected, I think, in the widespread appetite for books such as 'Body Keeps The Score' which evoke the concept of mental pain being 'held' in physical symptoms. Further, in my own clinical work (at least with the type and severity of patients I work) I am routinely impressed by the power of metaphor and symbolic thinking that help release suffering patients from the shackles of their illness. Often, this type of healing is not outside the realms of ethical and moral functioning, as is Sontag's assertion regarding physical illness, but often deeply and intimately intertwined with it.
  
  In all, this essay regularly gave me profound pause for thought, and I think I will carry it with me for years to come as I balance the scales between biological and psychological conceptions of illness.
  
  *Given the narrow scope with I read the essay, I am aware that that this review focuses on elements actually not covered by Sontag (besides her brief comments on 'madness' or 'insanity'). Her specific focus on the unnecessary moralisation and symbolisation of physical illness I unambivalently agree with.
• 
  Zahraa

  الانفعالات المثلى التي تدفع المرء للكتابة هي الغضب، الخوف أو الرعب. اذا اختبرت عواطف كتلك، سوف تعمل بلا أي مجهود.
  
• 
  Hameed Younis

  انكببت خلال الشهرين المنصرمين على ترجمة كتاب سونتاغ (المرض بوصفه استعارة) معتقداً أن الترجمة ستكون ذات فائدة وعون للقارئ العربي. لكن ما أن أعدت قراءة الكتاب وراجعته مرة أخرى، حتى وجدتني أعدل عن رأيي، وأستثني الموضوع برمته للأسباب التالية
  1- يتأمل الكتاب عموماً مجموعة أمراض تشترك بالغموض والرعب وصعوبة تشخيصها وعلاجها، بالإضافة إلى ثيمة الوصمة الاجتماعية والتصنيفات السلبية التي تحيط بها. ومن هذه الأمراض ذكرت: السرطان، والتدرن، والسفلس، والطاعون، وأخيراً الجنون
  2- كانت سوزان سونتاغ مصابة بسرطان الثدي في اثناء تدوينها الكتاب (حسب ما صرحت به في مقابلتها في باريس ريفيو)، ولذلك السبب أتخذ بحثها طابع سلبي وأحادي الجانب، وبلون موجوع، ومبالغ به في الضدّ من مرض السرطان ورؤية المجتمع له. وذلك يدلّك على حجم الألم والفقد الذي عانت منه الكاتبة لك الوقت. وهذا التوجه الأحادي قد ضرّ بالكتاب كثيراً، وإلا فكيف تأخذ بكتاب يكون عبئاً للمريض لا عوناً له في محنته
  3- لا يجدر بنا أن ننكر نجاح الكاتبة في تجميع أغلب الأدبيات التي تناولت السرطان والتدرن (إن لم نقل جميعها) وتحليلها ومن ثم تفكيكها
  4- استنتجت سونتاغ في نهاية الكتاب (ولا أظنها نجحت في مآلها) أن السرطان هو الوجه الحديث للتدرن الذي تفشى في القرن التاسع عشر، والذي كان بدوره الوجه الآخر للسفلس الذي تفشى قبله، وهكذا دواليك. أي إن المجتمع دائماً ما يتخذ أحد الأمراض ليكون له استعارة: ويجب أن يمتاز هذا المرض بالغموض، والفتك، والرعب، وصعوبة التشخيص والعلاج، لكي يتخذ كأمثولة يبنى عليه الاستعارات والتشبيهات
• 
  أبو فاطمة 14

  ليس من الخير أن يغدو المرض وصمة ذات حمل ثقيل ينوء به المريض داخل مجتمعه، وليس هناك عقوبة أشد من يعطى المرض معاني أكثر مما يحتمل و تفسيرات أسوأ من مجرد الخلل العضوي أو العدوى.
  
  اختيار الكاتبة للسل و السرطان جاء بسبب غموضهما الخبيث… لانهما يستنزفان المريض جسداً و روحاً و لأنهما استحقا بذلك تلك الرمزية السوداء التي تعشعش داخل افكار الناس والمجتمعات
  
  غريبة هي نظرتنا للمرض … نتعاطف مع بعض الأمراض و نمقت و نحتقر المصابين بأمراض أخرى
  نطلق ع��ى مرضى السرطان (ضحايا) و على المتعافين منه (ناجين) ،، تعابير عسكرية… هي حرب إذن!!
  لكن كيف ننظر للمصابين بالأمراض المنقولة جنسياً ؟… لمصابي نقص المناعة المكتسب (الأيدز) … المجذومين ؟ حتى للمصابين بالجرب؟
  
  ساعدني في استيعاب اكثر لهذا الكتاب، قراءاتي السابقة لكتاب The Emperor of All Maladies: A Biography of Cancer و لرواية عزيز محمد ( الحالة الحرجة للمدعو ك) و لسماعي لمحاضرات أصدقاء مرضى السرطان
• 
  Jana

  Sontag argues that a certain ideological cruelty resides in the metaphors commonly used to describe cancer and other illnesses. And when we let go of the metaphors, we can free ourselves (and those who are ill) from the tyranny of superstition, an over-excited imagination and blame.
  
  On a personal level, I get this. She's suffered; we've all suffered or known others who've suffered. And on page 101, she says that her aim is to "alleviate unnecessary suffering." On the same page, she also says that she didn't think it would be "useful" to write another narrative about how someone suffered, was comforted, took courage, etc. Ultimately, she felt an idea would be more useful than a narrative. And I get this... though I don't think the two are mutually exclusive... nor would I have rather read a narrative or expected her to write one, but that's not the point.
  
  The point for me, as an artist, and what I take issue with is the (now out-of-date) post-structural demonizing (feminizing) of metaphor as frivolous and impractical. There's a repressive quality in the call to quit metaphors and to the frantic empirical truth seeking. Not that I don't trust science or any such nonsense... just that stories don't undermine science any more than facts negate art practices. This is a long and complicated argument that I don't have space for here... so I'll just say:
  
  The work is important because it offers a critical lens to view harmful and thoughtless ideological myths, but how far do we really want to go to police language and stories? We learn a lot about ourselves and our culture through our metaphors and through critics like Sontag interpreting the beliefs behind the metaphors.
• 
  andreea.

  .
• 
  Nouru-éddine

  ::الانطباع العام::
  =-=-=-=-
  "أكثر الطرق صحة في نظر الشخص المريض لمرضه هي أن يتطهر منه، وأن يكون أشد الناس مقاومة للتفكير البلاغي واستعمال الاستعارات."
  في البداية كان عنوان الكتاب جاذبًا، لكن الكاتبة أوضحت أنها لن تتناول المرض من حيث كونه مرض، وبهذا في هذا الكتاب الفريد في نوعه ومجاله، تتناول الكاتبة تناولنا للمرض لغويًا، أي كيف نوظف المرض في لغتنا الخطابية اليومية أو الأدبية. وقد ركزت على عدة أمراض لها السيط الأوسع والتأثير الأكبر في حياة الإنسان قديمًأ وحديثًأ وهي: السل، السرطان،السيلان (الجزء الأول من الكتاب) الإيدز (الجزء الثاني من الكتاب).
  
  يتكون هذا الكتاب من كتابين صغيرين: المرض كاستعارة (1977)، والإيدز واستعاراته (1988)، وهو كتاب رائع بكل معنى الكلمة! فلك أن تتخيل هذه الكاتبة وهي تكتب هذا الكتاب، وأنت القارئ الذي رأيت أهوال جائحة 2019 المرضية، وتجد كل كلامها عن استعارات المرض قد تحققت بالحرف مع المرض الرئوي الوبائي الذي رأيناه! هذا الكتاب عبقري بكل معنى الكلمة، وكنت أتخيل ماذا كانت ستقول الكاتبة المتوفية 2004 لو رأت جائحة 2019؟!
  
  الاستعارة شيء خطير؛ فهي ذات نتائج حقيقية رغم أنها آتية من عالم المجاز. تسهم الاستعارات المجازية العسكرية في تشويه بعض الأمراض وبعض المرضى أيضًا. كان ينظر للسل نظرة عاطفية، بينما كان ينظر للسرطان بتقزز لاعقلاني على أنه تصغير وتحقير للذات. إن الغرض من هذا الكتاب هو تهدئة الخيال وتجريد الشيء من معناه المجازي. السرطان مرض خطير، لكنه ليس لعنة ولا وصمة عار وليس إحراجًأ أو إرباكًأ، إنه مجرد مرض والإصابة به لا تخلق هوية قد أفسدت بفعل المرض. "الاستعارات المجازية والخرافات تقتل."
  ::الكتاب::
  =-=-=-=-
  أولاً: المرض
  
  "يبدو أن المجتمعات بحاجة إلى مرض يعرف أنه مرض شرير ويلحق اللوم لضحاياه، ولكن من الصعب أن يستبد بنا ويثير بنا الهواجس أكثر من مرض." بعدما كان المرض عقابًا أخلاقيًا، أصبح المرض يعبر عن العواطف التي كبتها المريض الذي هو سبب المرض ويكون الحل بالنسبة إلى المريض هو تجاهل مرضه ظنًا أنه هو سببه. "إن التوقف عن اعتبار المرض عقابًا ملائمًا للشخصية الأخلاقية الموضوعية، وجعله تعبيرًا عن الذات الداخلية، يمكن أن يبدو أقل تزمتًا، لكن هذا الرأي يتضح أنه تمامًا مثل أو حتى أكثر تزمتًأ وعقابًأ بالنسبة للأمراض الحديثة (السل سابقًأ والسرطان الآن). فالمرض هو ما فعله العالم لضحية ما من ناحية، أما من الناحية الثانية فهو ما فعلته الضحية بعالمه وبنفسه."
  النظرية النفسية للمرض: يتوسع المرض بواسطة فرضيتين: الأولى هي أن كل شكل من الانحراف الاجتماعي يمكن أن يعد مرضًا. الثاني أن كل مرض يمكن أن ينظر إليه نظرة نفسية يفسر المرض أنه حدث نفسي في الأساس. الأولى تبرأ من الذنب، بينما الثانية ترجعه أو تعيده إلى وضعه السابق.
  المرض كاستعارة: إن أي مرض مهم كان سببه ضبابيًا وعلاجه غير مجد يميل لأن يكون مهمًا جدًا حيث تربط الموضوعات الأشد رعبًا مثل الفساد والانحلال والتفسخ والتلوث والشذوذ والضعف بالمرض أولاً ليصبح المرض نفسه استعارة. ثم وباسم المرض الاستعاري يفرض ذلك الرعب على أشياء أخرى ليصبح المرض صفة، شيئًا يقال أنه مثل المرض، والمقصود هو أنه يصبح مقززًا وبشعًأ.
  
  ثانيًا: السل
  على عكس السرطان، أعراض السل تفهم مبكرًا: النحول المستمر، السعال، الوهن، الحمى، الدم على المنديل، كل هذا يظهر بشكل مفاجئ ودراماتيكي. السل هو مرض التفسخ وتحطيم الجسم والحمى، إنه مرض تحول الجسم إلى سوائل أو إلى ما يسمى الأخلاط: بلغم، ومخاط وبصاق ودم وتتعاظم معه الحاجة إلى الهواء النقي. صور موت المريض بالسل دومًأ أنه جعل صاحبه أكثر جمالاً ومفعمًا بالعاطفة (بسبب احمرار الوجنتين من أثر الحمى). يتم اعتبار السل أن مرض الروح، فهو مرض الرئتين هو مجازيًأ مرض الروح، فهو المرض الذي يصيب جزءًا نبيلاً ورفيعًأ من الجسم. صور السل بديلاً عن مرض الحب وتم تعلقه بالعواطف. لقد جعل السل رومانتيكيًا أول مثال واسع الانتشار لذلك النشاط الحديث المميز لرفع مكانة الذات إلى صورة ذهنية. أصبحت نظرة المصاب بالسل التي أشارت إلى ضعف يثير التعاطف، وإلى حساسية عالية، النظرة المثالية للنساء، بينما أصبح رجال منتصف القرن التاسع عشر وآخره سمينين، وأسسوا إمبراطوريات صناعية، وكتبوا مئات الروايات وقاموا بالحروب ونهبو القارات. "إن الفكرة الرومانتيكية هي أن المرض يزيد الوعي بالألم تركيزَا. كان المرض مرة السل، والآن هو الجنون الذي اعتقد أنه يخضع الوعي أو الإدراك إلى حالة من التنوير المفاجئ."
  يستخدم عادة السل كاستعارة رومانسية، يخدم الرأي الرومانتيكي عن العالم، بينما السرطان الآن هو في خدمة رأي تبسيطي عن العالم يمكن أن يتحول إلى مرض جنون الاضطهاد أو الارتياط الذي هو نزعة الشك والارتياب من الآخرين.
  
  ثالثًا: السرطان
  وفقًأ لغالين فأصل اسم المرض من التشابه بين العروض المتضخمة أو المتورمة على الورم من الخارج وبين أرجل السرطان وليس كما يعتقد الناس أنه مرض انبثاثي ينتشر من مفره الأساسي إلى جزء آخر من الجسم يزحف مثل السرطان. الأعراض الرئيسة للسرطان تظل غير مرئية حتى اللحظة الأخيرة، أي عند فوات الأوان. السرطان هو مرض الانحلال والتفسخ، حيث تصبح أنسجة الجسم قاسية. السرطان حمل شيطاني. بينما صور الشخص الذي مات بالسرطان أنه جرد من كل قدراته ومن سموه الذاتي وتفوقه وأذل بالخوف والألم.
  لا ينظر أحد إلى السرطان بالنظرة نفسها التي تعد السل مرضًا تزيينيًأ، وتعده غالبًا موتًا حماسيًا ومثل الشعر الحماسي أو الملحمي، فالسرطان من الناحية الأخرى، هو موضوع نادر ومخز للشعر، ولا يتخيل أحد أنه يمكن أن يتعلق بعلم الجمال. ف حين أن السرطان هو مرض الجسد كله فهو حل على فشل المريض وكبته لعواطفه، كان السل هو مرض روحي يسمو بمريضه ويعطيه تبصرات قبل موته. لقد اعتقد أن مرضى السرطان في القرن التاسع عشر يصابون بالمرض نتيجة للنشاط المفرط والقوة المفرطة. حيث كان من المعتقد أن الشخص السعيد لا يصيبه المرض. السل استعارة متكافئة الضدين، عذابًأ أو كارثة وشعارًا أو رمزًا للنقاء أو الطهر والتهذيب، ولم ينظر إلى السرطان إلا كضرر أو كمصيبة؛ كان البربري الداخلي. السل هو عبارة عن تحويل الوعي أو الإدراك إلى شيء روحاني، بينما يفهم السرطان على أنه طغيان أو إلغاء للوعي. فالسل هو أنت تأكل نفسك المصفاة واصلا إلى القلب إلى الأنت الحقيقية، في السرطان الخلايا غير الذكية تتكاثر وتأكلك وأنت تزاح ويحل محلك اللاأنت ويصنف أطباء المناعة خلايا الجسم المناعية كـ لانفس، أو لاذات. لا تخصك.
  "إن الرأي الدارج وواسع الانتشار عن السرطان كمرض من أمراض الحضارة الصناعية هو غير متماسك علميًا بمقدار عدم تماسكه كوهم يميني لعالم خال من السرطان مثل عالم خال من المدمرات. إنه كليشة أن تقول إن البيئة تسبب السرطان كما كان ولا زال أن تقول أن العواطف التي تدار بشكل خاطئ هي التي سببه. كان السل على صلة بالتلوث، والسرطان الآن يعتقد أنه مرض التلوث في العالم كله. كان السل هو الوباء الأبيض مع الوعي بالتلوث البيئي، وقد بدأ الناس بالقول إنه يوجد وباء أو طاعون هو السرطان." - كان السبب هو ربط أسباب السرطان بانتقام الطبيعة من العالم التكنوقراطي الشرير، أي البحث عن كبش فداء يكون هو السبب في المرض لأنه كان ملوثًا أخلاقيًأ.
  يتم استعمال استعارة السرطان كمبرر راديكالي للاستئصال وأنه لا مناص أمامنا وأنه قد يؤدي هذا الحل إلى خسائر تجاه الأبرياء، لكنه لا مفر.
  ستصبح استعارة السرطان الراديكالية من طراز عتيق قبل أن نتمكن من حل المشكلات التي مثلتا هذه الاستعارة.
  
  رابعًا: السفليس
  يتم تعريفه أنه مرض سوقي. أًصبح تعبيرًا مجازيًا مثاليًا في الجدل والمناظرات المضادة للسامية في أواخر القرن التاسع عشر وأوائل القرن العشرين. فهو مرض يجلبه الشخص على نفسه، وأنه لا إرادي بشكل كامل.
  
  خامسًا: نقص المناعة المكتسبة
  إن الإصابة بالسرطان تفهم على أنها نتيجة لشخص ما انغمس في أسلوب حياة غير صحي كأن المرض عقوبة للعيش غير السليم، بينما السلوك غير الآمن الذي يؤدي إلى الإيدز يقيم على أنه أكثر من ضعف، إنه انغماس وتقصير وإهمال وإدمان على الكيماويات غير القانونية وعلى ممارسة الشذوذ الجنسي.
  
  سادسًا: قائمة مختصر لاستعارات الأمراض
  السل: ينظر له على أنه نشاط عاطفي ورومانسي مكثف ويطهر مريضه حتى وصوله لذاته
  السيلان ��المرض العقلي: ينظر لهما على أنهما نشاط عقلي محموم ومكافأة ينالها المريض لكي يبدع عملاً فنيًا مدويًأ
  السرطان والإيدز: ينظر لهما باعتبارهما أعداء ويجب محاربتهما عسكريًا لارتباطهما بالموت وضرورة الاستئصال الراديكالي لهما. والمريض بهما هو مذنب
  
  سابعًا: الرؤية التنبؤية للأوبئة
  إن الولع بالتنبؤ بالمستقبل خلق وعيًأ قلقًا بتوقع الكوارث بشكل مستمر، وأصبحت النظرة إلى المستقبل بعدما كانت مربوطة بتقدم الخطى والمعرفة المتوافرة لنا أكثر من أي أحد حلم به، كارثة! مما ولد لدنيا نوعين من الكارثة: الوباء الموجود لدينا، والوباء الموعودين به -عن طريق الاستقراءات الإحصائية المفزعة التي نراها كل يوم!!!- وهو مثل الحروب الموجودة حاليًا والحروب الأكثر ترويعًأ التي يمكن أن نواجهها في النهاية. هناك مصيبة كارثية باستمرار حدثت أو سوف تحدث. أصبح المستقبل هو هنا الآن مسبقًأ ودائمًأ أمامنا، هو الذي لا أحد يعرف كيف نرفضه.
  
  ثامنًأ: رسالة الكتاب
  "إن عملية اكتساب الأمراض للمعاني التي تبدو قديمة قدم التاريخ ولا يمكن معاندتها بأن تصبح الأمراض رموزًأ لأعمق المخاوف وتبلى الناس بوصمات العارف تستحق التحدي دائمًأ، ويبدو أن مصداقيتها محدودة في العالم المعاصر بين الناس الذين يريدون أن يكون عصريين، هذه العملية هي الآن تحت المراقبة والفحص. ومع هذا المرض الذي يثير كثيرًأ من الشعور بالذنب والعار الجهد الموجه لفصله عن هذه المعاني، هذه الاستعارات المجازية، يبدو أنها تحررية ومواسية.ولا يمكن إبعاد الاستعارات فقط بالامتناع عن استعمالها.يجب أن تُكشف وتُعرى وتنتقد وتهاجم ويسخر منها وتستهلك. إنها ليست مرغوبة فيها من أجل الطب،ولا من أجل الحرب، أن تكون كلية، ولا هي الأزمة التي أوجدها الإيدز مثلاً أي شيء كلي، نحن لسنا مستهدفين بالغزو،الجسم ليس أرض معركة، ليس المرضى إصابات لا يمكن تجنبها ولا العدو كذلك. نحن -الطب - المجتمع - لسنا مخولين أن نحارب حربًا دفاعية بأية طريقة كانت... حول تلك الاستعارة، الاستعارة العسكرية، أرغب أن أرجعها إلى صناع الحروب."
  ***
  
• 
  Mag

  Sontag, a cancer survivor at the time, wrote Illness as a Metaphor to explore and elucidate the metaphors used to describe serious illnesses like cancer and tuberculosis. Sontag argues that the metaphors and mythology created around these diseases make them seem evil and mysterious and very much like invincible predators, and hence sometimes prevent people from believing in conventional treatment to cure them. In addition, since cancer is seen as obscene, repugnant to the senses, and ill-omened, the person suffering from it is seen as morally, if not literally, contagious. Cancer occupies the spot reserved for TB in the past as a shameful disease meaning imminent death, but unlike TB, which was seen as a more ethereal, and metaphorically, a disease of the soul, cancer is definitely a disease of the body, and many times of its more shameful parts like colon or rectum. Both TB and cancer have been seen as diseases of passion- TB as a result of too much of it, and cancer as a result of too little.
  Sontag argues that patients are hardly helped by seeing and hearing all possible evils compared to cancer, and hopes that with advances in the treatment of cancer the metaphors will become obsolete.
  
  An interesting book, and since written before the times of AIDS very true about the place cancer and TB have been occupying in our mythology. Maybe a bit too repetitious. I did not realize how many famous people suffered from and died of tuberculosis.
  
• 
  Alien Bookreader

  An interesting look at how people tend to interpret things to have symbolic meaning, even when they are biological phenomena with biological origin. I think it is a product of human rationality, to look for causality in the world around us and in the process develop magical thinking, religion, mythology. So we end up creating a myth to describe the cause of each illness. That's my own hypothesis.
  
  Susan Sontag simply describes what she sees, that every illness has its own set of metaphors attached to it, given by the culture and the time. Is it self repression that leads to cancer? Is it a passionate personality that generates tuberculosis? A modern understanding of the true causes of illness still doesn't stop people from looking for symbols in these illnesses.
  
  Susan Sontag suggests that we stop believing in the metaphorical causes of illness. Because metaphors do not help us cope with illness, and ultimately metaphors are not objective. Relying on them to understand biological phenomena such as cancer only clouds our reality.
  
  I love Susan Sontag. One of me personal heroes.
• 
  سَنَاء شَلْتُوت

  هذه الدراسة تقوم على وصف الأمراض في الأعمال الأدبية الغربية على سبيل الاستعارة؛ أي كيف كان ينظر الأدب الغربي إلى المرض، بالإضافة إلى نظرة المجتمع بشكل عام للمرض ووصفه وطريقة التعامل معه ومع المريض.
  تناولت الكاتبة مجموعة من الأمراض مثل السل، والسفليس، والسرطان، والمناعة، والإيدز، والطاعون، والكوليرا، وقارنت بينهما و��يف كان رد فعل الناس إزاء كل مرض.
  ولكنها ركزت على الإيدز وطريقة تعامل الرجل الأبيض الذي يُعد هو (العالم) مع هذا المرض، أما بالنسبة لرجل العالم الثالث (الإفريقي)، والرجل الآسيوي فهم مجرد حالات تعيش في جزء من دورة طبيعية أي أن أمراض البلدان الإفريقية، والآسيوية الفقيرة هي مجرد شيء يعد مظهرًا من مظاهر الطبيعة.
  
  وكذلك كان جُل اهتمامها بالسرطان ذاك الحمل الشيطاني.
  كما تسعى الكاتبة بين السطور في هذه الدراسة إلى التحذير من أثر الفردانية الذاتية التي نعيشها، والتي يفرضها علينا العالم الرأسمالي بشكل كبير.
  وفي نهاية الدراسة فهي تحذر من استعمال الاستعارات العسكرية للمرض، ومن المعروف أنه لا يمكن إبعاد الاستعارات فقط بالامتناع عن استعمالها، بل يجب أن تُكشف وتُعرَّى وتُنتقد وتُهاجم ويُسخر منها وتُستهلك.
  وعلينا أن تعتبر أي مرض مجرد مرض، ليس لعنة، وليس عقابًا، وليس إحراجًا أو إرباكًا، بل هو مجرد مرض وفقط.
  
  ملحوظة: لا للمجاز.
• 
  Carolyn

  Herein, Sontag presents an excising polemic on the use of cancer and tuberculosis as metaphors of evil in (respectively) the Romantic and industrialized eras of modern society. Unfortunately, this diatribe is neglectful of non-Western cultures and carries a certain sense of an overly-personal motive. Sontag grasps desperately at every little data point in history suggesting at her thesis. As a result, the author repeatedly rehashes concepts with a frequency that is tiring for a mere 85-page novelette. Furthermore, Illness as Metaphor fails to consider an effective counter-argument; i.e. not taking into account the nature of language itself as metaphor, diminishing the role of other metaphors for societal evil, limiting exemplary components of the argument to literary references. While this work certainly highlights the apt intellectitude of its writer, it falls short of a thorough development of the issues it presents. A fascinating central concept, but its presentation is sadly pallid.
• 
  Prithu

  The book could easily pass off as a work of master autoethnographer. Angry at times, the book is mostly nonchalant. Given the fact, her own experience with cancer does not get featured in this monograph, and the prose posits itself as an objective essay, I reserve that initial thought to myself.
  
  There are few observations which felt like contrivances to make her point (especially the cancer portions a bit). Few instances appeared to be surreptitiously personal (though the tone is objective throughout). Sontag is brilliant in pointing out the pigeonholing of a disease into a specific character trait. Popular narratives and the collective imagination of a 'romantic' disease grossly undermine the onerous suffering of the patient. Some observations are so bizarre and unfortunate that they become funny predicaments at times. A great read nonetheless. Would be a definite recommendation.
• 
  Korri

  I only finished this in the wee hours of this morning--I need to reflect but I want to capture my first impressions & understandings. Sontag traces the language we use to discuss tuberculosis and cancer, with the former often referred to in romantic/aesthetized terms. In the case of both cancer and TB, Sontag argues, society has a notion that a type of personality is particularly prone to the illness, that the illness reveals something about the self and thus it can be cured if only the patient has the right temperment/will/strength of character. By using illness as a metaphor, we mystify it and make it more difficult to talk about/treat.
  
  But that's only a part of her argument and the most developed part at that. The part about using illness as a metaphor in society (ex: National Socialism calling Jews a cancer) felt sort of tacked on at the end without deep engagement.
  
  I have not read the updated text with its inclusion of HIV & AIDS. It was the lack of discussion about AIDS that caught my attention upon reading the jacket cover--I wondered how relevant the book could be without referencing the hysterical rhetoric & moral judgement associated with the disease. For what it is--a discussion of the literal & figurative language associated with tuberculosis & cancer in 19th and 20th century literature--the book is useful.
• 
  Marija

  Published in 1978, “Illness As Metaphor” testifies to attitude towards cancer patients and it brings out a specific history of aversion through examples from literature and philosophy. Although a progression from pure psychological prejudgment to accurate scientific improvement in cancer treatment has certainly been made since 1978, this book retains its topicality.
  
  The study exposes insightful analogy of two different illnesses, exploring the boundaries of their broader cultural and historical frame. In the same time, it evokes new perspectives on perception and understanding of those fatal conditions through questioning already established metaphorical thinking. The paradigm of the study consists of TB, once romantically perceived “as a pretext for leisure, and for dismissing bourgeois obligations in order to live only for one's art” and cancer which is “not so much a disease of time as a disease or pathology of space.”
  
  “Illness As Metaphor” successfully discusses the language of metaphor, fear of death through adopted symbolical thinking from the ancients to modern times and social condemnation based on associated personality types, which are attributed to disease emergence and development.
  Susan Sontag succeeded in providing a critical approach to social norms based on preconceived beliefs and examined certain social values deeply rooted in human subconsciousness.
• 
  Gui Nabais Freitas

  Sontag makes a tightly packed argument about the ways in which illness has simultaneously been romanticised and placed on the patient making them the cause of their own illness, when they should be the seen as the victim. She uses the case studies of Tuberculosis and Cancer to argue the different ways in which they have been seen as illnesses which certain personality types are prone to. She ties this nicely to the way in which they are (or in the case of TB were) so mythologized being due to the unawareness of the causes and proper, complete treatment; she further demonstrates her point by arguing that syphilis, a disease contemporaneous with TB, did not have any specific mythology around it or its victims as people knew who they were and how they contracted it.
  
  The second half of the book details the idea of illness as a metaphor in the political and social spheres. We have probably all heard or read of 'x' being described as 'cancerous'. She details the potential problems this has, including offering an admission of her own difficulties with this when she famously called the 'white race' a 'cancer'.
  
  Her discussion of illness as metaphors highlights, as she herself argues, the shallowness of our culture's view of death, as well as a helpless romanticism which is really the secular myth of self-transcendence. An engaging and thought-provoking read.
• 
  Arlie

  This is so interesting, I can't believe it took me so long to get around to reading it.
  
  I started reading it after a day and a half of having being shut in my room with a cold, not really seeing anyone and feeling kind of dramatic. And it was really soothing. The stuff about cancer as metaphor for middle class repression and emotional restraint made me think a lot about people I know with potentially fatal/terminal/incurable illnesses who have gone on the Gawler diet or similar; my mum and her partner are really into it and she once told me that "breast cancer is just something you never got off your chest".
• 
  Brent

  I reread this for first time since 1970s in the middle of my own challenges last year.
  Sontag is clear in writing about health speech, or ill health comparisons.
  God bless and keep her.
  Highly recommended.
• 
  Michelle

  3.5/5
  
  I wished I had taken notes so I can better articulate my thoughts, but essentially I found it an enlightening read that I'm glad to have absorbed.
  
  Sontag brings up some valid points about the way we regard diseases, especially tuberculosis and cancer. I haven't before viewed how often literature likens TB to be an affliction deeply connected with the person and his/her creative faculties instead of it just simply being an ailment.
  
  She dives deep into how writers often romanticize TB but disparage cancer, and of how those two compare and contrast. I found myself heavily agreeing with her when she mentioned how often villains in literature (or in whatever fictionalized medium, really) were portrayed to have some type of illness, as if the disease they're afflicted with were a symptom of their moral deficiency.
  
  It's true that we often associate cancer with death due to its fatalistic nature (at least when it was first presented), ineluctable (again, when first presented) because of the mystery behind its cause. I don't know that we necessary regard cancer patients as inherently having a default of character/expressiveness, as Sontag seems to claim most people do; but then again, I wasn't there when cancer was first discovered.
  
  Sure, we use cancer (and other illnesses) as a metaphor a lot, but it's such a destructive force. I don't advocate for a total abolition of its figurative use since I believe that anything can be used as a metaphor; however, I do understand wanting to remove the stigma. Is this perhaps a little dated now that research has proven that cancer is not an effect of character, or can we still not separate the disease from the person? I admit that it's extremely difficult not to think of the clock ticking when someone mentions their battle against cancer (and yes, I realize that Sontag takes issue with its militaristic associations), but does anyone still regard it as a punishment? (Actually, I can think of some who might want to have a word about that . . .)
  
  On the negative end, Sontag makes some pretty big presumptions. I don't think think her conclusions are entirely cogent. As much as her arguments are, as I conceded, valid, I'm not convinced enough. I'd elaborate on this, but I'm a lousy reviewer.