Constructing Paris Medicine (review)

Constructing Paris Medicine. Edited by Caroline Hannaway and Ann La Berge (Amsterdam, Editions Rodopi B.V., 1998) pp. 406. $100.00 cloth, $36.00 paper.

This exceptionally coherent set of papers, by a distinguished group of historians of medicine, drastically modifies the conventional interpretations of the Paris Clinical School (1794-1848) by Ackerknecht and Foucault.¹ It attributes the rhetorical construction of heroic innovation to the professional and political agendas of physicians and historians. Laurence Brockliss argues that ancien régime medical students already had access to hospital training and instruction in pathological anatomy; the allegedly sharp break with the past was the prorevolutionary propaganda of "doctrinaire egalitarians" (92). This interpretation seems dubious if the label is intended for moderate medical reformers such as Félix Vicq d'Azyr.

Othmar Keel pursues his long-standing contention that anatomical and tissue pathology was a product of the British Hunterian tradition, rather than a unique development of the Paris School. W. R. Albury argues astutely that the real novelty in the physiology of Jean-Nicolas Corvisart and François-Joseph-Victor Broussais was the reconceptualization of organic weakness as dangerous individual pathology, without a healing force of nature. The necessary remedy was active intervention, preferably in hospitals. Thus, physicians enhanced their professional power in focusing on internal pathology rather than external symptoms.

Several essays take issue with the concept of a monolithic Paris school. Jacalyn Duffin highlights the failure to achieve a common medical discourse in the rivalry between René-Théophile-Hyacinthe Laennec--a royalist and Catholic--and the flamboyant, anticlerical Broussais. In the only markedly interdisciplinary essay, L. S. Jacyna employs the insights of art history to show how the royalist, religious Jean-Louis Alibert, in an illustrated account of skin diseases, departed from much-vaunted scientific objectivity to evoke affective responses from his readers.

Several other historians also challenge the insistence of Ackerknecht that the Paris school declined after 1848 because, unlike German laboratory medicine, they ignored the auxiliary medical sciences. La Berge finds that a strong faction of clinicians supported the new techniques of microscopists despite sometimes overambitious claims for the new instrument. Joy Harvey uses the medical press and the letters of Paul Broca and Mary Putnam to show that a younger generation of clinicians preserved the vitality of the Paris School well after 1848. John Harley Warner, a historian of American medicine, questions the criterion of visiting American students as a measure of medical leadership. Until 1855, visiting foreign students flocked to Paris for ease of access to personalized instruction in hospitals and in dissection.

Though not largely an interdisciplinary work, this volume will be an invaluable resource for all historians of medicine seeking the most recent scholarship on eighteenth and nineteenth-century Paris clinicians.

Martin S. Staum
University of Calgary

Note

1. Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception (New York, 1973; orig. pub. Paris, 1963); Erwin Ackerknecht, Medicine at the Paris Hospital, 1794-1848 (Baltimore, 1967).

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