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89 4 Blood-Letting and Septic Surgery An Introduction to Selections from Gustave Flaubert’s Madame Bovary Gustave Flaubert (1821–1880) is unquestionably one of the very greatest French novelists of all time, and his Madame Bovary (1857) an acknowledged masterpiece of world literature. Flaubert himself came from an eminent medical family; his father was for twenty-five years chief of the hospital in Rouen, the main city in the province, Normandy, where Madame Bovary takes place, and where his brother, too, was a leading doctor. Flaubert took special care to assure the accuracy of the details about the surgery Charles Bovary, Emma’s husband, performs by reading up on it in medical textbooks. Charles is not a fully qualified physician but an officier de santé (health officer), a much lower rank corresponding to the British “surgeon ” of the time or to today’s physician’s assistant. And even at this level he has had much difficulty in passing the examinations, failing at his first attempt. The difference in training and prerogatives between physicians and health officers was considerable. Candidates for the doctorate in mid-nineteenth-century France had to spend four years at a medical school, pass five demanding examinations, and compose and defend a dissertation in Latin. Health officers, on the other hand, were required to do only three years of schooling and an undemanding oral examination , or alternatively a six-year apprenticeship. With the advances in medicine in the latter half of the century, heated debates took place 90 Blood-Letting and Septic Surgery about the dangers to the public from scantily trained health officers. In Madame Bovary Dr. Canivet laments the “disrepute” brought to a “sacred calling” by health officers (see the fourth selection, “Surgery”). Yet despite their relative ignorance, health officers were deemed necessary to provide some health care for the rural peasant population. Efforts to abolish this class of practitioners, begun in 1847, finally succeeded in 1892. Meanwhile the proportion of health officers in France dropped from 40 percent of medical personnel in mid-century to a mere 10 percent by the 1890s. Health officers were stringently restricted in what they were allowed to do. They could practice only in the state in which they were licensed so that the Bovarys could move from one place to another in Normandy but no further. Health officers were permitted to deal solely with mild, straightforward cases. Thus Charles remains fully within his rights in attending to Rouault’s broken leg (described in the first selection, “A Broken Leg”); he recognizes it as a simple fracture that will heal itself in time with rest, and is quite ingenious in improvising a splint and bandages out of materials available on the farm. He plays the role of physician by uttering the words of comfort he thinks appropriate to a doctor and repeating gestures and phrases used by his teachers. In accordance with the custom of the time, Charles is invited to partake of refreshments so that the visit has a social as well as a medical dimension. In attending to Rouault’s leg, Charles gets to meet Emma and to become aware of her attractiveness. His success in mending the leg (by leaving it to mend itself!) establishes his reputation among the peasants. Dimly conscious of his own limitations, Charles is extremely cautious, prescribing mainly soothing medications. Charles is well liked by his peasant clientele (see the second selection, “Settling into Practice”) because he is good-natured and prudent in his treatments, sticking to the standard remedies of his day such as bleedings and emetics. His solid moral character, his modesty, even his very blandness endear him to his naive patients, eliciting their trust. The insinuation is that he is not far above their level intellectually. Unlike Trollope’s Dr. Thorne (chapter 2) or George Eliot’s Lydgate in Middlemarch (chapter 5), Charles is not at odds with the social reality in which he works, but this happy consonance stems from a common mediocrity. Although the initial glimpses of Charles’s professional activity present a rather favorable image, readers are from the outset also made aware of his innate shortcomings : his knowledge of and interest in medicine are quite superficial, he is by nature inclined to timidity, and his primary method to achieve success is to do as little as possible. This less complimentary view of [18.216.124.8] Project MUSE (2024-04-26...

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