The Great Nation in Decline: Sex, Modernity and Health Crises in Revolutionary France c.1750-1850 (review)

Sean Quinlan's new work explores the degree to which worries about health and degeneration existed in France before the nineteenth century. Quinlan argues that doctors, intent on improving individual health, demonstrated a 'health activism' that ultimately changed French society. 'Health activists', he argues, 'hoped to use biomedical science to transform the self, sexuality, and community in order to regulate a sick and decaying nation' (p. 4). From the personal to the public, medical reformers believed that by controlling pain and sickness, physicians 'could . . . transform the human condition' (p. 56). Worries about depopulation also pushed reformers to take action; Quinlan explains that reformers' concerns encouraged doctors to engage in public discussions about health and social conditions in France. For example, when those in knowledgeable circles believed that 'invisible pathologies were rotting the body politic from within,' (p. 57) doctors addressed the issue in written tracts and lectures. Ultimately, doctors' activities changed how Parisians viewed occupational health. For example, physicians focused on the use of mercury in trades and the ways that factory owners addressed the effects of factory conditions on workers' health (pp. 75–76). Quinlan emphasizes that physicians made recommendations on ways to transform labour practices to improve workers' safety and health (p. 76). He argues that this points to 'doctors' anxieties about labour sedition and industrial change, but it also shows how they understood disease in terms of group behaviour' (p. 76). The author argues that 'by approaching health problems in group terms, practitioners could better study social pathologies and . . . regenerate the sick kingdom' (p. 77). One of the most significant changes in public health policy came as Parisian doctors addressed the effects of vapours on the population of Paris. When waste disposal and cemeteries in the middle of the city came under the scrutiny of eighteenth-century physicians, profound changes occurred (pp. 80–82). Stories circulating in elite and popular circles claimed that when grave workers opened crypts they 'were attacked by mephitic gas and fell into states of apoplexy, hysteria and syncope—often fatal' (p. 83). By 1781 the dangers of vapours from the city's cemeteries reached a breaking point and police closed them. However, odours and vapours continued to emanate from the closed areas. Doctors' complaints and advice literature focused attention on the problem and the government moved decaying remains from several of the city's cemeteries (p. 84). In this book, Quinlan demonstrates the influence doctors had on French social heath, public policy, and law. Early chapters of The Great Nation in Decline focus on the revolutionary and post-revolutionary periods; all address effectively French doctors' deep concerns about individual health and its role in national decline. Those familiar with nineteenth-century arguments about the body and degeneration will find this work a valuable contribution to the field.