Les mots Du Corps: Expérience de la maladie dans les lettres de patients à un médicin du 18e siècle: Samuel Auguste Tissot by Séverine Pilloud (review)

As is evident in the subtitle of the book, this is a study of a doctor’s patients, not a study of a doctor. The Swiss physician, Samuel Auguste Tissot, gained a European renown in the second half of the eighteenth century thanks to his widely disseminated self-help medical manual, Avis au people sur santé, and his equally popular works on masturbation, nervous diseases, and the maladies of the rich and the learned. As a result, he received large numbers of letters from people all over Europe seeking relief from their chronic maladies. Pilloud’s book is a study of some thirteen hundred letters and memoranda sent to the Swiss doctor in the course of his career, which today are to be found in the second part of the Fonds Tissot in the Bibliothèque cantonale et universitaire of Lausanne, the town in which Tissot practiced. The first part of the book introduces the reader to the correspondents. They came from as far afield as Lisbon, Edinburgh, and St. Petersburg; there were almost as many women as men; and they came from all sections of society except the very bottom. Some employed medical intermediaries to put their case, but most either wrote themselves or were introduced to Tissot by one of their family. The second and larger part of the book explores what they had to say for themselves. Pilloud’s aim is to discover how eighteenth-century people (the profanes, as she calls them) thought and talked about their bodies, and the letters provide abundant information. Tissot’s patients had a good grasp of contemporary medical science, which they used to describe their ailments and suggest a diagnosis. But their medical vocabulary was eclectic: most were quite happy to construct a narrative of their medical history which drew on Galenic, iatrochemical, and iatromechanist ideas, and there was no sign of a shift in the middle of the century toward a pathology specifically built on the nervous system. At the same time, many patients were particularly versed in Tissot’s own works: they wrote to the physician because they had read one of his books and were convinced that he, unlike other practitioners, had the measure of their malady. Patients were also remarkably frank about their ailments and showed little constraint in describing their sexual activity or details of their bodily evacuations.

The popular eighteenth-century practice of consulting by letter has been explored by several medical historians in the past twenty-five years. For the most part, however, historians have concentrated their attention on the consultations written by the physicians, not the letters of the patients. Witness the recent book by Robert Weston on the practice in France, which devotes only a single chapter to the patient’s point of view.¹ This reflects the surviving evidence: there are very few collections of patients’ letters but lots of collections of physicians’ consultations, many of which were printed by their author. Tissot was peculiar: he kept the incoming letters but did not preserve his replies, which can generally be guessed at only from his annotations on the original requests. He was also peculiar in the number of patients who approached him. Among his contemporary physicians only Tronchin of Geneva and Cullen of Edinburgh appear to have attracted more. Pilloud’s book is therefore an extremely important contribution to our understanding of a practice that was part of a wider eighteenth-century fascination with both writing letters and using the letter to bare all. While as a work of body history it follows in the footsteps of Barbara Duden’s classic account of the patients of an Eisenach doctor about 1730² and the more general study of Michael Stolberg,³ it surpasses both...