La medecine a Geneve jusqu'a la fin du dix-huitieme siecle (review)

The author of this classic work in the history of medicine was a graduate of the Paris Faculty of Medicine, a practitioner in his native Geneva, and a dedicated autodidact in the history of medicine. As noted in the introduction, the work—affectionately known to locals as "le Gautier"—has long been regarded as an indispensable resource for the history of medicine in Geneva. The occasion for its reprinting was the 125th anniversary of the founding of the Geneva Faculty of Medicine.

The stated reasons for this reissue of Gautier's work, aside from commemorative sentiments, are its grounding in a vast range of archival sources, its standing as the only synthetic work covering the history of medicine in Geneva in the early modern era, and its interest as a historical "object" (p. xxvii) in its own right. The editors' claims to the work's value are all justified. Genevan science and medicine have only recently begun to attract the attention they deserve from historians, and medicine in particular has been neglected. Thus Gautier's synthetic work remains an essential point of departure for new inquiries. Of tremendous value to historians is the direct culling Gautier undertook of extensive archival sources, especially the three hundred volumes of the Registre du Conseil. The resulting account, presented in the positivist "fact-by-fact" style favored circa 1900, is filled with close historical detail on both general themes and the biographies of individual practitioners. The volume ends with three appendices: a list of physicians, apothecaries, and surgeons of the period; a bibliography of their published works; and selected documents such as the text of the 1569 ordonnances that set medicine in Geneva on the path of formal certification.

As historical "object," Gautier's work presents a fascinating view of the prejudices and anxieties of European physicians at the beginning of the twentieth century. Although Gautier never explicitly analyzed any theme, claiming that readers would be interested in "facts not reflections" (p. xxv), he returned regularly to issues that troubled many physicians of his era. These included, above all, the long-term effort of medical figures to secure their professional standing and a monopoly of health care in the face of official interference, the skepticism and fatalism of patients, and, especially, the competition of "irregular" healers. For Genevan physicians, whose formal training conferred superior standing over the other two "corps" of apothecaries and surgeons, this was a task made more difficult by the fact that Geneva had no university and thus did not offer regular medical instruction or degrees. Trained and degreed abroad, Genevan physicians were therefore always the beneficiaries of prestige borrowed from foreign institutions. Nor did medical figures in Geneva show much interest in founding private courses and learned societies to compensate for the lack of university training; such moves came only in the eighteenth century, and then only haltingly. Thus the efforts of Genevan practitioners to secure a special role and a protected livelihood were chiefly directed at gaining legal support from officialdom. The authorities did progressively move to close medical practice to Jews, women, non-Genevans, the heterodox, and those without diplomas or demonstrated skills—but, Gautier laments, to the very end of the Republic there was a "profound discord" (p. 283) between law and fact.

Aside from this account of professionalization, three chapters devoted to the great scourges of leprosy, plague, and smallpox supply vivid quotidian detail: the stipulated right of lépreux to leave their institutions to fulfill the "conjugal duty"; the banning of all public gatherings, but required attendance...