Doctors
The care a nation takes of its health always reveals a lot about its attitudes to life. In France,
the medical
profession is particularly interesting, for there is a political dimension to its influence. Its rise to
power in
the state is one of the striking features of this century. There were 15 doctors in the Assembly
of 1789, 26 in that of 1791, 40 in the Convention.
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About a dozen served in the smaller Restoration Chamber of Deputies
and 28 in that of July.
In 1848, 49 of the constituents were doctors, and in 1849, 34 of the legislators. There were 11 in Napoleon III's
Corps Legislatif of 251 members, 33 in the National Assembly of 1871, but by 1898 their number had risen to 72. It may
be argued from these figures that doctors gradually replaced the old landowning class and in some cases the clergy as
leaders of public opinion and that in the Third Republic they reached the zenith of their prestige and
influence.
But to say this is to beg many questions: it is to assume that doctors were not also landowners, that their influence
was an alternative and opposed to the old notable class, that the
profession meant the same thing over 150 years, that the opportunities open to doctors were unchanging, and that
their appearance in parliament always represented an acknowledgement of their influence, rather than that the doctorswere seeking new fields in which to act, to compensate for difficulties they were experiencing in the exercise of their
profession.
Medicine in France in this period was in fact in a state of confusion and division as total as that which afflicted politics.
It is impossible to paint a picture of doctors as the products of a new science whose capacity and skill were gradually
established, recognised and accepted. There was no one medical science, and the rivalry between the different theories
was as merciless and disruptive as the cut-throat competition of commerce. In 1850 the medicine of cure by bleeding,
purging and the administration of enemas was still in existence, for all the discoveries of the capital cities, whose
doctrines were slow to penetrate the countryside. The efforts of Voltaire's doctor Tronchin (1709-81) and his school to
replace this by the use of fresh air, exercise, vegetarianism, water-drinking, breast-feeding and vaccination were slow
to win acceptance.
The enlightenment even saw a regression to the doctrine of vitalism- the belief that a mysterious vital
element regulates the organs and fights death. This doctrine was taken up by the faculty of medicine of Montpellier and
taught by it till the twentieth century so that Paris and Montpellier taught medicine in radically different ways., The
training which the doctors practising between 1850 and 1900 received preserved the strangest errors taught by men
highly esteemed in the first half of the century. One of these, to take an example, was Broussais (1772-1838), a man of
great eloquence, imposing presence, and unrelenting combativeness, who wielded great power in the medical world.
He imagined that the cause of all diseases was inflammation, particularly in the intestines. He prescribed
abundant blood-letting, leeches and severe diets. His starving patients, bled white, died like flies, but he was
nevertheless made a professor at the faculty of Paris ( 1831) . When towards the end of his career his star waned
and his students turned elsewhere, he took up phrenology and his very popular lectures on this gave him a second lease
of life. Equally influential but at a more popular level was F. V. Raspail (1794-1878), whose Natural History of Health
and Illress (1843) and annual en-cyclopedias (1846-64) became best sellers as manuals of self medication: he advocated
camphor as the cure for all diseases.
Possibly the single most successful doctor of the nineteenth century was Philippe Ricord ( 1800-89), personal
physician to Napoleon III and the national expert on syphilis. Born in Baltimore, the son of a bankrupt French shipowner,
he rose to become Paris's busiest and possibly richest doctor . His house in the rue de Tournon contained five large
salons for his patients to wait in: one for ordinary people, always crammed full and each given a number, one for women,
who entered by a separate staircase, one for people with letters of recommendation, and a fourth for friends and doctors.
All were decorated magnificently with paintings and sculptures, for he was a great collector. An enormous fifth
reception salon had two Rubens, a Van Dyke, Gericaults, etc. His office contained on three walls a large library
surmounted by a gallery of busts of the great physicians of all time, underneath it glass cases with Paris's best
collection of surgical instruments and on the fourth wall portraits of his masters Dupuytren and Orfila, and one of
himself by Couture. He was France's most decorated celebrity after Alexandre Dumas, with seventeen medals: he was
popular not leat for being a man of the world, indulgent to his patients and famous for his witticisms.' His Treatise
on Venereal Diseases (1838) did rightly distinguish between gonorrhoea and syphilis, but he insisted that the latter
was not contagious through secondary lesions : he continued to administer his incorrect doctrine to all the rich of
Europe, despite the discoveries of the more obscure Joseph Rollet of Lyon (1856).
Extract from “France 1848 – 1945 Ambition & Love”, by Theodore Zeldin. Oxford University Press,
Britain:1979.
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