Incurable and Intolerable: Chronic Disease and Slow Death in Nineteenth-Century France

310 Pages·2009·1.915 MB·English

by  Jason Szabo

Incurable and Intolerable

V V V V V V V V V V V
Incurable and Intolerable
Chronic Disease and Slow Death in
Nineteenth-Century France
JASON SZABO
V V V V V V V V V V V
RUTGERS UNIVERSITY PRESS
NEW BRUNSWICK, NEW JERSEY, AND LONDON
LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA
Szabo, Jason, 1965–
(cid:5)Incurable and intolerable : chronic disease and slow death in nineteenth-
century France / Jason Szabo.
(cid:5)(cid:5)p. ; cm.
(cid:5)Includes bibliographical references and index.
(cid:5)ISBN 978–0–8135–55–5 (hardcover : alk. paper)
 1. Chronic diseases—France—History—19th century.(cid:5)2. Palliative treatment—
France—History—19th century.(cid:5)I. Title.
(cid:5)[DNLM:(cid:5)1. Chronic Disease—psychology—France.(cid:5)2. History of Medicine—
France.(cid:5)3. History, 19th Century—France. WZ 70 GF7 S996i 2009]
(cid:5)RA6.8.F8S93 2009
(cid:5)616'.0—dc22 200803531
A British Cataloging-in-Publication record for this book is available from the
British Library.
Copyright © 2009 Jason Szabo
All rights reserved
No part of this book may be reproduced or utilized in any form or by any means,
electronic or mechanical, or by any information storage and retrieval system,
without written permission from the publisher. Please contact Rutgers University
Press, 100 Joyce Kilmer Avenue, Piscataway, NJ 0885–8099. The only exception to
this prohibition is “fair use” as defi ned by U.S. copyright law.
Visit our Web site: http://rutgerspress.rutgers.edu
Manufactured in the United States of America
To the memory of my parents

CONTENTS
Acknowledgments ix
Introduction 1
(cid:1)1 “What Are His Chances, Doctor?” The Semantics of
Incurability in the Nineteenth Century 15
2 Reinventing Hope in the Late Nineteenth Century 37
(cid:2)3 “I Told You So”: The Rhyme and Reason of Chronic Disease 58
4 Death, Decay, and the Genesis of Shame 70
5 Medical Attitudes toward the Care of Incurables 90
6 Medical Strategies, Social Conventions, and
Palliative Medicine 113
7 Ecce Homo: Opiates, Suffering, and the Art of Palliation 136
8 The Good, the Bad, and the Ugly: Incurability and the
Quest for Goodness 159
9 The Fate of the Incurably Ill between the Two
Revolutions, 1789–1848 175
10 Caught between Initiative and Inertia: Responses to the
Incurably Ill from 1845 to 1905 197
Conclusion 216
Notes 223
Select Bibliography 277
Index 289
vii

ACKNOWLEDGMENTS
Many years went into writing this book, and during this time I have enjoyed the
support of a large number of individuals and institutions. First and foremost,
I’d like to thank my mentor George Weisz, whose vast knowledge and probing
criticisms were a source of inspiration. His many kindnesses helped me see
this project to the end.
I also want to thank my family for their love and support. Dominique
Leydet helped me in countless ways as this project took shape. My daugh-
ters, Béatrice and Claire, have been a constant source of joy and wonder. My
research trips and writing deadlines were a perennial distraction, and I hope
that they agree that the fi nal product was worth the time and eff ort.
Numerous friends, colleagues, and associates have also been tremen-
dously helpful. My colleagues at the Montreal General Hospital—particu-
larly Dr. Chris Tsoukas—consistently supported my endeavors, even when
requests for protected time were anything but convenient. Diane Daoust,
Gail Pucci, and Debbie Cutler generously helped out with all forms of techni-
cal assistance. At various points, Donna Evleth, Robbie Cutler, Annie-Claude
Thériault, Marianne Di Croce, and Theresa Howard assisted me in amassing
and cataloguing the many source documents. The staff at McGill’s Osler
library—Pamela Miller, Christopher Lyons, Lily Szczygiel, and Mary Dixon—
always cheerfully responded to my queries. Deanna Cowan, Ingrid Dixon, and
the other reference librarians did a remarkable job tracking down an array
of nineteenth-century books and articles. Without their devoted eff orts, it
would have been impossible for me to complete this research.
I also benefi ted from the fi nancial assistance of numerous funding agen-
cies and foundations. These included the Social Sciences and Humanities
Research Council, Associated Medical Services, the Canadian Institutes of
Health Research, and the Montreal General Hospital Foundation. Two indi-
viduals in particular, William Seidelman and Ron Collett, generously sup-
ported my work as a physician and as a historian.
Various friends and colleagues have read all or parts of this book. James
Vatistas, Sebastian Normandin, Thomas Schlich, and Alberto Cambrosio
were important sounding boards as the book was taking shape and read
ix
x ACKNOWLEDGMENTS
early versions of the manuscript. I also benefi tted from suggestions from the
members of the history of medicine working group at Harvard University.
Beyond providing an example of impeccable historical scholarship, my post-
doc supervisor, Charles Rosenberg, provided helpful suggestions on several
particularly thorny sections. And in an exemplary display of collegiality,
Harry Marks and David Barnes generously read the manuscript on two sepa-
rate occasions. Their criticisms were at once insightful and constructive, and
they deserve much credit for helping me take this book to the next level.
I would also like to express my gratitude and aff ection to my friend and
partner Andrea Tone. An accomplished historian and fi rst-rate writer, she
carefully read the entire book at a critical moment in its genesis. Her editing
suggestions, along with those of Elke Kluge, Ann Youmans, and particularly
my editor at Rutgers, Doreen Valentine, made it much stronger than it would
otherwise have been. Her encouragement, along with that of the wonderful
editorial group at Rutgers University Press, made fi nishing this project more
enjoyable than I ever imagined.
Finally, I would like to thank my parents, John and Jeannette, neither of
whom lived to see this book completed. Without their love and support, I
would never have taken on a project such as this, and I dedicate this book
to their memory.