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Journal of the History of Medicine and Allied Sciences 59.1 (2004) 149-150



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Elizabeth A. Williams. A Cultural History of Medical Vitalism in Enlightenment Montpellier. Burlington, Vermont, Ashgate Publishing, 2003. viii, 369 pp. $99.95.

Although historians have long recognized the importance of vitalism to French medicine, an accessible study of the subject has long been wanting. This situation has now been reversed with the appearance of two excellent books, Roselyne Rey's posthumously published Naissance et développement du vitalisme en France de la deuxième moitié du 18e siècle à la fin du Premier Empire (Oxford: Voltaire Foundation,2000), and the book under review here, Elizabeth A. Williams, A Cultural History of Medical Vitalism in Enlightenment Montpellier.

Both of these books trace the vitalist "medical current" (Rey's term) from its emergence in the middle of the eighteenth century, through its rise to prominence in the second half of the century, to its eventual eclipse around the time of the French Revolution. The intellectual story the authors tell is largely the same: Both see vitalism as a response to the mechanistic models of the body that had dominated French medicine since Descartes; both identify vitalism with, in Williams's words, "an emphasis on variability over uniformity, the suspicion of mathematics, the singularity of the human, and, with it, the art of medicine" (p. 162); both stress the complex relation of vitalism to the various intellectual currents that made up the Enlightenment; and both argue that the ideas and theories that had their source in the vitalist thought of the eighteenth century continued to shape French medicine well after the vitalist movement itself fell into decline.

There are, of course, differences in interpretation and emphasis in each author's account of this story. Rey, for instance, places the reconceptualization of irritability in terms of a notion of sensibility at the center of her account, while Williams stresses vitalism's central role in the creation of a medical anthropology—a "science of man" in which the human became "the singular preserve of physicians and of medicine" (p. 275). (This was the topic of her first book, The Physical and the Moral: Anthropology, Physiology, and Philosophical Medicine in France, 1750 - 1850 [Cambridge: Cambridge [End Page 149] University Press, 1994]). Whereas Rey gives a conceptual history, Williams examines vitalism through the lens of cultural history, situating it in the practical, professional, and institutional context of medicine in Montpellier. In the second chapter, for instance, Williams examines vitalism as a "university product": the theory developed "largely in the university, much of the impetus for its development came from university teachers, and the ultimate fate that vitalism met as a distinctive medical discourse was tied to the fate of the university" (p. 51). Court connections, the practical needs of the physician, salon culture, the Encyclopedia—each of these, Williams argues, played an important role in the development of vitalism in Montpellier.

Williams also considers Montpellier vitalism as a form of local knowledge. In the first chapter, she argues that the "quotidian circumstances of medical life in Montpellier encouraged a medicine that was closely attuned to the physical and social landscape in which it developed" (p. 40). She further develops this theme with respect to the complex interplay between Paris and Montpellier, center and periphery, court and province. Williams seeks here to decenter the Enlightenment, shifting our attention away from Paris, without, however, simply counterposing province to center. Rather, she depicts Montpellier vitalism in terms of the relationship between the production of knowledge in Paris and in Montpellier, both sites participating in the broad intellectual trend known as the Enlightenment, but each contributing in ways specific to local circumstances and institutional needs.

In this respect, Williams's work dovetails with recent trends in the history of eighteenth-century thought and culture. Williams does not go so far as some scholars to deny the very existence of the Enlightenment. But she does argue for a broader understanding of Enlightenment thought, an Enlightenment that "was more complicated, diverse...

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