Histoire sociale de la medecine (XVIIIe-XXe siecles) (review)

Abstract

Reviewed by: Histoire sociale de la médecine Martha L. Hildreth Olivier Faure. Histoire sociale de la médecine (XVIIIe–XXe siècles). Historiques. Paris: Anthropos, 1994. 272 pp. F 130.00 (paperbound). Olivier Faure, a professor at the University of Clermont-Ferrand, is one of the leading historians of French medicine in the modern era. His earliest work focused on the social history of hospitals and was pioneering in that field. More [End Page 156] recently he has investigated smallpox vaccination, tuberculosis, homeopathy, and the distribution of medical practitioners. Histoire sociale de la médecine is a short survey of key topics within the history of French medicine from the eighteenth century through the first half of the twentieth. However, the era from the Société royale to the First World War is the principal subject matter. Readers expecting a social history focusing upon practices, remedies, customs, clients, and practitioners, will be disappointed in this work. Instead they should turn to another of Faure’s works, Les français et leur médecine au XIX e siècle, which provides a more comprehensive survey of social and cultural aspects of medical history in that century. 1 While there is some overlap between the two works, Histoire sociale de la médecine emphasizes principal diseases and connected scientific medical ideologies. It discusses the relationship between etiological concepts, epidemics, and the practical developments of therapies and prevention. To cover so much material over such a long period is a daunting task. Thus Faure organizes each era thematically around a set of antitheses. In what must be an acknowledgment of Jacques Léonard’s La médecine entre les savoirs et les pouvoirs, 2 Faure subtitles the three sections of his book: “La médecine entre Molière et Jenner,” “La médecine entre Jenner et Pasteur,” and “La médecine entre succès et échecs.” As a result he highlights major turning points in French medicine that are well known: the rise of clinical medicine, the introduction of vaccination, and the cholera and tuberculosis epidemics of the modern era. Faure states his desire to avoid being caught between great men/great ideas, on the one hand, and a social history of maladies and physicians, on the other. He wants to do a history of the changing and ambiguous relationships within society between illness and cure—an analysis that he recognizes as privileging change. He writes that he wishes to explain change, not by the internal logic of medicine, but rather by attending to medicine within culture and society. However, the strength of the work is in Faure’s analysis of the relationship between changing scientific ideologies, therapeutic innovations, and actual medical practices. Broader issues of culture, politics, and social change enter into the analysis only in the most general ways. The discussion of cholera, for example, examines efforts to analyze the disease through existing etiological concepts of theorists such as Magendie, Broussais, Roche, and Bretonneau, discussing the limitations of those approaches and of their connected therapeutic practices. Faure points out that although clinical concepts were able to isolate the disease process within specific organ systems, standard therapies were clearly not adequate. As patients searched for alternatives, homeopathy gained the ground that the savants were losing. The volume provides a valuable summary of most of the major work of French scholars in the social history of medicine of the last two decades—particularly that of Jacques Léonard and of Faure himself, and, for the period after 1880, that of Bruno Latour and Anne-Marie Moulin. Faure’s generalizations sometimes [End Page 157] obscure issues that are treated in more complex ways in the literature he invokes. He remarks, for example: “Le rôle politique des médecins au XIXe siècle n’a dans ce contexte rien d’étonnant. Faire la politique, c’est faire de la médecine par d’autre moyens” (p. 115)—whereas Jack Ellis has pointed out nearly the opposite situation: that for most physician-legislators what is remarkable is the degree to which their political lives were inspired and governed by issues having little to do with medicine. 3 Faure also remarks that “Contrairement...