Medical Consulting by Letter in France, 1665-1789

241 Pages·2013·1.16 MB·English

by  Robert Weston

Medical Consulting by Letter
in France, 1665–1789
Robert Weston
Medical consulting by letter
in France, 1665–1789
the History of Medicine in context
series editors: andrew cunningham and ole Peter grell
department of History and Philosophy of science
university of cambridge
department of History
open university
titles in the series include
Female Patients in Early Modern Britain
Gender, Diagnosis, and Treatment
Wendy d. churchill
Plague Hospitals
Public Health for the City in Early Modern Venice
Jane l. stevens crawshaw
Bad Vibrations: The History of the Idea of Music as Cause of Disease
James Kennaway
‘Regimental Practice’ by John Buchanan, M.D.:
An Eighteenth-Century Medical Diary and Manual
edited by Paul Kopperman
Anatomical Dissection in Enlightenment England and Beyond:
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edited by Piers Mitchell
Healing, Performance and Ceremony in
the Writings of Three Early Modern Physicians
M.a. Katritzky
Medical consulting by letter
in France, 1665–1789
robert Weston
University of Western Australia
© robert Weston 2013
all rights reserved. no part of this publication may be reproduced, stored in a retrieval
system or transmitted in any form or by any means, electronic, mechanical, photocopying,
recording or otherwise without the prior permission of the publisher.
robert Weston has asserted his right under the copyright, designs and Patents act, 1988,
to be identified as the author of this work.
Published by
ashgate Publishing limited ashgate Publishing company
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union road suite 3-1
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British Library Cataloguing in Publication Data
a catalogue record for this book is available from the british library
The Library of Congress has cataloged the printed edition as follows:
Weston, robert, 1938-
Medical consulting by letter in France, 1665-1789 / by robert Weston.
pages cm. -- (the history of medicine in context)
includes bibliographical references and index.
isbn 978-1-4094-5217-1 (hardcover) -- isbn (invalid) 978-1-4094-5218-8 (ebook) 1.
Medical consultation--France--History. 2. Patient participation--France--History. i. title.
r727.42.W47 2013
610--dc23
2012033534
isbn 9781409452171 (hbk)
isbn 9781409452188 (ebk – PdF)
isbn 9781409465003 (ebk – ePub)
III
Printed and bound in great britain by the
MPg books group, uK.
Contents
List of Tables vii
Notes on the Text ix
Acknowledgements xi
Introduction 1
Background 2
Methodology 8
Terms and Concepts 9
Structure 11
Part I Contexts: textual, ProfessIonal and soCIal
1 Correspondence: Practices and Context 17
Survey and Collection Techniques 17
The Manuscript Sources 18
Printed Consultations 23
The Structure of Medical Correspondence 28
The Veracity of Printed Sources 30
The Practitioners of Medical Correspondence 34
Epistolary Consultations as Reflections of Medical Practice 35
2 The Dynamic Medical Marketplace 43
Defining the Boundaries between Physicians and Surgeons 45
Surgeons and their Roles 50
The Roles of Paramedicals 57
The Presence of Empirics and Charlatans 59
The Cost of Medical Treatment 65
3 Relationships between Medical Correspondents 71
Family Involvement in Medical Correspondence 73
Hereditary Disorders 79
A Case Study of Venereal Diseases 81
Gender-based Distinctions 84
4 Knowledge, Status and Power: Negotiating Authority 93
Establishing Authority 95
Inter-practitioner Authority 102
vi MEDICAL CONSULTING BY LETTER IN FRANCE, 1665–1789
Negotiating Diagnoses 105
Negotiating Treatments 109
Part II Body, HealtH and Illness
5 University Medical Knowledge in Epistolary Practice 115
The Longevity of the Hippocratic-Galenic Curriculum 116
Alternative Theories, Iatrochemistry and Iatromechanics 119
Driving the Machine 123
Debates about Nosography and Nosology 125
The Learned View of Pathology, Illness and its Diagnosis 128
Evidence of Diagnosis and Prognosis 131
6 Patients’ Perceptions of the Body, Health and Illness 139
Perceptions of Health and Disease 139
Patients’ Rhetoric 142
Patients in Pain 143
Describing the Body 145
The Perception of Death 147
Patient Knowledge 149
Hypochondria: Patient Perceptions and Practitioner Advice 152
7 The Deployment of Therapies 161
Phlebotomy Revisited 163
Medicinal Therapies 167
Imbibing Mineral Waters 170
Bathing 170
The Materia Medica 172
Lifestyle and Diet 177
Self-medication 181
8 From Complaint to Cure 183
Epilepsy – Examining Therapeutic Options and Rationales 183
Therapeutic Efficacy 196
Conclusion 201
Bibliography 205
Index 223
List of Tables
1.1 Number of consultations written by physicians and surgeons 29
6.1 Percentage incidence of different names for hypochondria
used in relevant cases 153
8.1 Summary of epilepsy analysis 188
8.2 Uses of different treatment proposals for epilepsy compared
with all diseases in the consultations 189
8.3 Frequency of use of the most common purgatives in
cases of epilepsy 191
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Notes on the Text
All translations from the French are the author’s own. Original quotes in French
have only been retained when translation is ineffective or because the French was
deliberately obfuscated by the original author.
The orthography employed in the seventeenth and eighteenth centuries was
markedly different to that of modern French. The spelling of many words and
the use of accents was inconsistent. As a consequence, the original has been
maintained. For consistency the term physician is used rather than doctor; firstly
to avoid any possible confusion with the more numerous doctors of theology and
law, and secondly to encompass individuals who studied and practised medicine
and who had obtained licences in medicine but had not proceeded to gain a
doctoral bonnet. Only where the original text refers to un docteur has that been
used. The terms médecin ordinaire and chirurgien ordinaire are used for local
practitioners to differentiate them from the high-profile practitioners who were
consulted. The tem ordinaire recurs constantly in the correspondence and is not
intended to imply the individuals concerned were holders of an official position
with prominent figures, such as the upper echelons of the Court, another use made
of the term. In instances where it is not possible to identify whether the individual
was a physician or surgeon, the term ordinaire alone is employed, or to encompass
either when more than one individual is involved.
Letters from patients, or their local physicians and surgeons, to consultants
are referred to by the most common term employed, mémoire. In the sources, the
consultants’ responses were either termed consultations or réponses; throughout
this text the term consultation is employed.